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黏膜及黏膜下胃肠道病变切除术及双内镜经验

Resection of Mucosal and Submucosal Gastrointestinal Lesions and a Double Endoscope Experience.

作者信息

Çolak Şükrü, Gürbulak Bünyamin, Çakar Ekrem, Bektaş Hasan

机构信息

Istanbul Training and Research Hospital, Department of General Surgery, Fatih, Istanbul, Turkey.

出版信息

JSLS. 2019 Jan-Mar;23(1). doi: 10.4293/JSLS.2018.00096.

DOI:10.4293/JSLS.2018.00096
PMID:30880899
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6408942/
Abstract

AIM

The patients who underwent endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for mucosal and submucosal lesions of the esophagus, stomach, and duodenum and the advantages of the double endoscope method we used for traction during ESD were evaluated.

MATERIAL AND METHODS

The patients who underwent ESD and EMR due to upper gastrointestinal lesions were evaluated retrospectively between January 2014 and April 2018 in our endoscopy unit.

RESULT

The mean age of 10 patients with esophageal lesions was 53 years. ESD was performed for 7 lesions and EMR for 3 lesions. The most common lesion was leiomyoma and the median size of the lesions was 1.4 cm (range, 0.6-2.5 cm).The median age of 26 patients with gastric lesions was 61 years. EMR were performed for 11 lesions and ESD for 15 lesions. Double endoscope was used in 6 patients. One patient had intramucosal carcinoma, while the other lesions were benign and dysplasia was the most common lesion. The median size of lesions was 1.8 cm (range, 1-3 cm).All lesions were evaluated with endoscopic ultrasonography. Bleeding was seen in 4 patients and perforation in 1 patient during ESD and defect was closed with endoscopic clips.

CONCLUSION

The advantages of endoscopic resections; short hospitalization, low complication rates, patient comfort, and doesn't require the general anesthesia. For endoscopic resection, we think that the second endoscope shortens the duration of the procedure, reduces the complication rate, and increases the comfort of the endoscopist.

摘要

目的

评估因食管、胃和十二指肠黏膜及黏膜下病变接受内镜黏膜切除术(EMR)和内镜黏膜下剥离术(ESD)的患者,以及我们在ESD过程中用于牵引的双内镜方法的优势。

材料与方法

回顾性评估2014年1月至2018年4月在我们内镜科因上消化道病变接受ESD和EMR的患者。

结果

10例食管病变患者的平均年龄为53岁。7例病变行ESD,3例病变行EMR。最常见的病变是平滑肌瘤,病变的中位大小为1.4 cm(范围0.6 - 2.5 cm)。26例胃病变患者的中位年龄为61岁。11例病变行EMR,15例病变行ESD。6例患者使用了双内镜。1例患者为黏膜内癌,其他病变均为良性,发育异常是最常见的病变。病变的中位大小为1.8 cm(范围1 - 3 cm)。所有病变均通过内镜超声进行评估。ESD过程中4例患者出现出血,1例患者出现穿孔,缺损用内镜夹封闭。

结论

内镜切除术的优势在于住院时间短、并发症发生率低、患者舒适度高且无需全身麻醉。对于内镜切除术,我们认为使用第二根内镜可缩短手术时间、降低并发症发生率并提高内镜医师的舒适度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc0d/6408942/4d6d09446142/jls0201637630002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc0d/6408942/b2ec54cf26b9/jls0201637630001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc0d/6408942/4d6d09446142/jls0201637630002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc0d/6408942/b2ec54cf26b9/jls0201637630001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc0d/6408942/4d6d09446142/jls0201637630002.jpg

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