Álvarez Delgado Alberto, Pérez García Maria Luis
Aparato Digestivo, Hospital Universitario de Salamanca, España.
Medicina Interna, Hospital Universitario de Salamanca, España.
Rev Esp Enferm Dig. 2021 Dec;113(12):810-812. doi: 10.17235/reed.2021.8437/2021.
Over the last few years early esophageal tumors, whether squamous-cell or associated with Barrett's esophagus, have been excised using endoscopic resection techniques, primarily endoscopic submucosal dissection (ESD). Esophageal surgery-associated morbidity and mortality are thus avoided with similar oncologic outcomes. ESD is not without complications, many of which arise and are endoscopically solved during the procedure itself (bleeding, perforation, etc.). Other complications develop within days or weeks after resection, these including mainly esophageal stricture. Esophageal strictures following ESD are initially managed with endoscopic balloon dilation (EBD). Preventive measures have been suggested to alleviate this complication, primarily by using local or systemic steroids in association with early dilation. Even so, not always may they be prevented. Such complications are called refractory strictures, which require either esophageal stents (in a majority of cases) or surgery.
在过去几年中，早期食管肿瘤，无论是鳞状细胞癌还是与巴雷特食管相关的肿瘤，都已通过内镜切除技术进行切除，主要是内镜黏膜下剥离术（ESD）。这样就避免了食管手术相关的发病率和死亡率，同时肿瘤学结果相似。ESD并非没有并发症，其中许多并发症在手术过程中出现并通过内镜解决（出血、穿孔等）。其他并发症在切除后的几天或几周内出现，主要包括食管狭窄。ESD术后的食管狭窄最初通过内镜球囊扩张术（EBD）进行处理。已经提出了预防措施来减轻这种并发症，主要是通过联合使用局部或全身类固醇以及早期扩张。即便如此，但它们并非总能被预防。这类并发症被称为难治性狭窄，需要放置食管支架（大多数情况下）或进行手术。
