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食管鳞状细胞癌手术切除后胃管癌内镜切除的疗效与安全性

Efficacy and safety of endoscopic resection for gastric tube cancer after surgical resection of esophageal squamous cell carcinoma.

作者信息

Hirayama Yoshie, Fujisaki Junko, Yoshimizu Shoichi, Horiuchi Yusuke, Yoshio Toshiyuki, Ishiyama Akiyoshi, Hirasawa Toshiaki, Imamura Yu, Mine Shinji, Watanabe Masayuki, Tsuchida Tomohiro

机构信息

The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koto, Tokyo, 135-8550, Japan.

出版信息

Esophagus. 2019 Apr;16(2):194-200. doi: 10.1007/s10388-018-00653-w. Epub 2019 Jan 1.

Abstract

BACKGROUND

Gastric tube cancers (GTCs) are found frequently, even as the surgical outcomes of esophageal cancer improve. Diagnosing and treating early gastric tube cancer endoscopically has therefore become very important.

AIMS

This study aimed to evaluate the clinical characteristics and outcomes of endoscopic resection for GTC.

METHODS

We analyzed 29 patients (33 lesions) with metachronous GTC who underwent endoscopic resection from April 2005 to August 2016 and evaluated their clinical characteristics and the short-term outcomes of endoscopic resection.

RESULTS

All of the cases were identified by periodic examinations. The lesions were found a median of 6.5 years after surgery (range 9 months-19 years), with six lesions found more than 10 years later. Among the total of 33 lesions, 28 resulted in curative resections (85%), and five were non-curative resections because of lymphovascular invasion, submucosal deep invasion, histological type, and size. None had received additional treatment or had a local recurrence thus far. Regarding the complications, delayed perforation occurred in a case (3%) and precordial skin burn occurred in four cases (12%).

CONCLUSION

The safety and efficacy of endoscopic resection for gastric tube cancer were evaluated. Additionally, it is important to continue annual endoscopy even 5 years or more after esophageal surgery.

摘要

背景

尽管食管癌的手术疗效有所改善,但胃管癌(GTC)仍较为常见。因此,通过内镜诊断和治疗早期胃管癌变得非常重要。

目的

本研究旨在评估胃管癌内镜切除的临床特征及疗效。

方法

我们分析了2005年4月至2016年8月期间接受内镜切除的29例异时性胃管癌患者(33个病灶),并评估了他们的临床特征及内镜切除的短期疗效。

结果

所有病例均通过定期检查发现。病灶在手术后中位6.5年被发现(范围9个月至19年),其中6个病灶在10年以后被发现。在总共33个病灶中,28个实现了根治性切除(85%),5个因存在脉管侵犯、黏膜下深层浸润、组织学类型及大小等因素而未实现根治性切除。目前尚无患者接受额外治疗或出现局部复发。关于并发症,1例发生延迟穿孔(3%),4例发生心前区皮肤烧伤(12%)。

结论

评估了胃管癌内镜切除的安全性和疗效。此外,即使在食管手术后5年或更长时间,继续每年进行内镜检查也很重要。

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