Zhu Rui, Ma Cui-Yun, Min Min
Department of Gastroenterology, Fifth Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2022 May;53(3):381-385. doi: 10.12182/20220560503.
Endoscopic submucosal dissection (ESD) has been widely used in the clinical treatment of early-stage and precancerous lesions of the digestive tract. Compared with traditional open surgery, the procedure has a number of advantages, including low postprocedural recurrence rate, the location and scope of lesions not posing much restrictions on the procedure, and quick patients recovery afterwards. The procedure has hence become one of the minimally-invasive procedures commonly performed with gastrointestinal endoscope. However, due to the influence of various factors, complications such as intraoperative and postoperative bleeding, perforation, electrocoagulation syndrome and lumen stenosis may occur. Delayed postoperative bleeding, in particular, may induce cardiovascular and other related diseases due to the insidious nature of its onset, resulting in serious consequences. It is critically important for the further development of ESD that we should acquire thorough understanding and mastery of the relevant influencing factors and preventive measures of delayed bleeding after ESD of early-stage gastrointestinal cancer. We herein summarized and discussed the latest research findings in the preventative and treatment measures.
内镜黏膜下剥离术(ESD)已广泛应用于消化道早期及癌前病变的临床治疗。与传统开放手术相比,该手术具有诸多优势,包括术后复发率低、病变的位置和范围对手术限制不大以及患者术后恢复快等。因此,该手术已成为胃肠内镜常见的微创手术之一。然而,由于各种因素的影响,可能会出现术中及术后出血、穿孔、电凝综合征和管腔狭窄等并发症。特别是术后延迟出血,因其发病隐匿,可能诱发心血管等相关疾病,导致严重后果。深入了解和掌握早期胃肠道癌ESD术后延迟出血的相关影响因素及预防措施,对ESD的进一步发展至关重要。我们在此总结并讨论了预防和治疗措施的最新研究结果。