Hsu Wen-Hung, Wu Tzung-Shiun, Hsieh Meng-Shu, Kung Yu-Min, Wang Yao-Kuang, Wu Jeng-Yih, Yu Fang-Jung, Kuo Chao-Hung, Su Yu-Chung, Wang Jaw-Yuan, Wu Deng-Chyang, Hu Huang-Ming
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Cancer. 2021 Jan 1;12(3):765-770. doi: 10.7150/jca.47653. eCollection 2021.
Endoscopic submucosal dissection is minimal invasive endoscopic procedure to deal with gastric tumor. Initially, it was developed to resect mucosal neoplasm since 2000 and extended its application to submucosal tumor in the following years. Although the basic ESD skills are similar in gastric mucosal tumor and subepithelial tumor, the success rate, complication may be different between the two types of gastric tumor resection. This retrospective study is conducted to analyze the ESD procedure in gastric mucosal tumor and subepithelial tumor. From 2007 to 2016, we reviewed all patients who underwent endoscopic submucosal dissection for gastric mucosal tumor and subepithelial tumor in Kaohsiung Medical University Hospital. Totally, 35 patients with gastric subepithelial tumor and 41 patients with gastric mucosal tumor received endoscopic submucosal dissection are enrolled. Among 35 patients with subepithelial tumor, 32 (91.4%) patients achieved curative treatment. 1 patient received emergent operation and 2 patients received salvage operation to complete tumor resection. 8 patients (22.9%) occurred perforation and no delay bleeding was found. Among 41 patients with mucosal neoplasm, 30 (71.4%) patients achieved curative treatment. 2 patients received emergent operation and 9 patients received salvage operation to complete tumor resection. 9 patients (21.9%) occurred complication, 6 patients occurred delay bleeding and 3 patients had perforation. Comparing ESD between gastric mucosal tumor and subepithelial tumor, ESD had similar efficiency in curative treatment. However, ESD in subepethelial tumor encountered higher perforation and lesser delay bleeding.
内镜黏膜下剥离术是一种用于治疗胃肿瘤的微创内镜手术。最初，它自2000年起被开发用于切除黏膜肿瘤，并在随后几年将其应用扩展到黏膜下肿瘤。尽管胃黏膜肿瘤和上皮下肿瘤的基本ESD技术相似，但这两种类型的胃肿瘤切除在成功率、并发症方面可能有所不同。本回顾性研究旨在分析胃黏膜肿瘤和上皮下肿瘤的ESD手术情况。2007年至2016年，我们回顾了高雄医学大学附属医院所有接受内镜黏膜下剥离术治疗胃黏膜肿瘤和上皮下肿瘤的患者。共有35例胃上皮下肿瘤患者和41例胃黏膜肿瘤患者接受了内镜黏膜下剥离术并被纳入研究。在35例上皮下肿瘤患者中，32例（91.4%）患者获得了根治性治疗。1例患者接受了急诊手术，2例患者接受了挽救性手术以完成肿瘤切除。8例患者（22.9%）发生了穿孔，未发现延迟出血。在41例黏膜肿瘤患者中，30例（71.4%）患者获得了根治性治疗。2例患者接受了急诊手术，9例患者接受了挽救性手术以完成肿瘤切除。9例患者（21.9%）发生了并发症，6例患者发生了延迟出血，3例患者发生了穿孔。比较胃黏膜肿瘤和上皮下肿瘤的ESD，ESD在根治性治疗方面效率相似。然而，上皮下肿瘤的ESD穿孔发生率较高，延迟出血较少。
