Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea,
Digestion. 2019;99(3):219-226. doi: 10.1159/000491592. Epub 2019 Feb 22.
BACKGROUND/AIMS: The mucosal healing process after endoscopic submucosal dissection (ESD) is mostly scarring change (flat type), but a protruded lesion is occasionally found. We investigated the factors influencing the mucosal healing process, such as the flat and protruded types.
A total of 2,096 ESD cases were performed from February 2005 to December 2013, and 1,757 underwent follow-up endoscopy after 3 months to check the healing type of the ulceration. We retrospectively reviewed the medical charts to analyze demographic, endoscopic, and pathological findings between the 2 groups.
Forty-eight cases were of the protruded type and 1,709 were of the flat type. In univariate analysis, the protruded type was found more in the antrum, anterior wall, and greater curvature (p < 0.001). In protruded types, the Helicobacter pylori (H. pylori) infection rate was lower (p < 0.017), the mean length of ESD specimen was shorter (p < 0.012), the fibrosis rate was lower (p < 0.033), and the mean number of hot biopsy and clips during ESD were less (p < 0.008 and p < 0.001 respectively).
The healing type of mucosal ulceration after ESD seemed to be influenced by location, specimen size, and the presence of an H. pylori infection.
背景/目的：内镜黏膜下剥离术（ESD）后的黏膜愈合过程多为瘢痕改变（平坦型），但偶尔会发现凸起性病变。我们研究了影响黏膜愈合过程的因素，如平坦型和凸起型。
回顾性分析 2005 年 2 月至 2013 年 12 月期间进行的 2096 例 ESD 病例，其中 1757 例在术后 3 个月进行了随访内镜检查，以检查溃疡的愈合类型。我们分析了两组之间的人口统计学、内镜和病理发现。
48 例为凸起型，1709 例为平坦型。单因素分析显示，凸起型更多见于胃窦、前壁和大弯侧（p < 0.001）。在凸起型中，幽门螺杆菌（H. pylori）感染率较低（p < 0.017），ESD 标本的平均长度较短（p < 0.012），纤维化率较低（p < 0.033），ESD 期间热活检和夹钳的平均数量较少（p < 0.008 和 p < 0.001）。
ESD 后黏膜溃疡的愈合类型似乎受部位、标本大小和 H. pylori 感染的影响。
