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内镜黏膜下隧道剥离术与内镜黏膜下剥离术治疗食管胃结合部黏膜下浅层肿瘤的对比:来自中国单中心的病例对照研究。

Comparison between endoscopic submucosal tunnel dissection and endoscopic submucosal dissection for superficial neoplasia at esophagogastric junction: a case-matched controlled study of a single center from China.

机构信息

Department of Gastroenterology, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.

出版信息

Surg Endosc. 2022 Nov;36(11):8371-8378. doi: 10.1007/s00464-022-09289-5. Epub 2022 Jul 18.

Abstract

BACKGROUND

So far, little evidence is available for the comprehensive comparison of endoscopic submucosal tunnel dissection (ESTD) with endoscopic submucosal dissection (ESD) for the treatment of superficial neoplasia at esophagogastric junction (EGJ).

METHODS

EGJ superficial neoplasia patients with ESTD treatment between January, 2021 and August, 2020 were retrospectively reviewed and individually matched at 1:1 ratio with those with ESD treatment according to lesion size, specimen area and lesion location, forming ESTD and ESD group, respectively. A sample size of 17 patients was collected for each group. Treatment outcomes including resection time, specimen area, and resection speed as well as occurrence of complications were evaluated.

RESULTS

Compared with ESD group, ESTD group got shorter resection time (111.00 ± 11.70 min for ESD group vs. 71.59 ± 6.18 min for ESTD group, p = 0.008) and faster section speed (0.23 ± 0.03 cm/min for ESD group vs. 0.37 ± 0.06 cm/min for ESTD group, p = 0.012). No complication was found to occur in ESTD group, while 1 patient with MP damage and 1 with delayed bleeding was found in ESD group.

CONCLUSION

For the treatment of EGJ superficial neoplasia, ESTD is a safer and more effective and reliable endoscopic technique compared with ESD.

摘要

背景

目前,对于治疗食管胃交界(EGJ)处的表浅性肿瘤,内镜黏膜下隧道剥离术(ESTD)与内镜黏膜下剥离术(ESD)的综合比较尚缺乏充分证据。

方法

回顾性分析 2021 年 1 月至 2020 年 8 月期间采用 ESTD 治疗的 EGJ 表浅性肿瘤患者,并根据病变大小、标本面积和病变位置,按 1:1 比例与采用 ESD 治疗的患者进行个体匹配,分别纳入 ESTD 组和 ESD 组,每组收集 17 例患者。评估两组的治疗结局,包括切除时间、标本面积和切除速度以及并发症的发生情况。

结果

与 ESD 组相比,ESTD 组的切除时间更短(ESD 组为 111.00 ± 11.70 min,ESTD 组为 71.59 ± 6.18 min,p = 0.008),切片速度更快(ESD 组为 0.23 ± 0.03 cm/min,ESTD 组为 0.37 ± 0.06 cm/min,p = 0.012)。ESTD 组未发生并发症,ESD 组有 1 例发生黏膜穿孔损伤,1 例发生延迟性出血。

结论

与 ESD 相比,ESTD 是一种更安全、更有效、更可靠的治疗 EGJ 表浅性肿瘤的内镜技术。

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