Tan Yuyong, Qing Yumin, Liu Deliang, Gong Jian
Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha 410011, China.
Research Center of Digestive Disease, Central South University, Changsha 410011, China.
J Clin Med. 2023 Oct 13;12(20):6509. doi: 10.3390/jcm12206509.
(1) Background: Endoscopic submucosal dissection (ESD) has been widely accepted as the standard method for treating early-stage cancer or precancerous lesions in the upper gastrointestinal tract; however, it may be difficult in patients with liver cirrhosis due to clinical challenges such as coagulation dysfunction, presence of gastroesophageal varices, etc. We aimed to demonstrate the safety and efficacy of ESD in these populations. (2) Methods: The clinical data of patients were retrospectively collected and analyzed. Inclusion criteria of the study were: a. patients with liver cirrhosis; b. patients who underwent ESD; c. patients who were diagnosed with early-stage cancer or precancerous lesions in the upper gastrointestinal tract. (3) Results: Eight patients were enrolled from April 2019 to April 2023, of whom three were male and five were female, with ages ranging from 43 to 70 years old. Seven lesions were located in the stomach and one other lesion was in the esophagus. ESD was performed successfully in all eight patients, and the resected lesion size ranged from 2 to 6 cm. Only one patient encountered postoperative complications, namely, chest pain and fever. No recurrence was noticed during a follow-up of 3 to 45 months. (4) Conclusions: ESD may serve as a safe and effective method for treating upper gastrointestinal early-stage cancer or precancerous lesions in patients with liver cirrhosis.
（1）背景：内镜黏膜下剥离术（ESD）已被广泛接受为治疗上消化道早期癌症或癌前病变的标准方法；然而，对于肝硬化患者而言，由于存在凝血功能障碍、胃食管静脉曲张等临床挑战，实施该手术可能存在困难。我们旨在证明ESD在这些人群中的安全性和有效性。（2）方法：回顾性收集并分析患者的临床资料。本研究的纳入标准为：a.肝硬化患者；b.接受ESD治疗的患者；c.被诊断为上消化道早期癌症或癌前病变的患者。（3）结果：2019年4月至2023年4月共纳入8例患者，其中男性3例，女性5例，年龄在43至70岁之间。7个病变位于胃部，另1个病变位于食管。所有8例患者均成功实施了ESD，切除病变大小在2至6厘米之间。仅1例患者出现术后并发症，即胸痛和发热。在3至45个月的随访期间未发现复发情况。（4）结论：ESD可作为治疗肝硬化患者上消化道早期癌症或癌前病变的一种安全有效的方法。
