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[内镜下黏膜切除术用于早期胃癌及癌前病变的切除]

[Endoscopic mucosectomy for resection of early gastric cancer and precancerous lesions].

作者信息

Zhou L, Lin S, Ye S

机构信息

Department of Gastroenterology, Third Hospital, Beijing Medical University.

出版信息

Zhonghua Nei Ke Za Zhi. 1995 Jul;34(7):443-5.

PMID:8556922
Abstract

The authors collected 14 cases of early gastric cancer located in the mucosa and precancerous lesions which were resected with endoscopic mucosectomy. These lesions were as follows: 6 cases were early cancer (IIc type: 4 cases; IIa type: 2 cases); 3 cases were severe dysplasia; 5 cases were adenoma, Yamada I type. The size of all the lesions was less than 20mm. Four cases of early gastric cancer were resected completely. Two cases were resected incompletely, but radical gastrectomy was performed one month after endoscopic mucosectomy. All the three cases of severe dysplasia had complete resection. But two of them received resection twice. Five cases of adenoma were also resected completely. The criteria of complete endoscopic resection were those reported in the Japanese literature. All cases have been followed up for 4-41 months; endoscopic and histological studies showed that there were no residual and recurrent cancer cells. The complete resection rate was 85.7% (12/14). The results suggest that endoscopic mucosectomy can be applied to the patients with early gastric cancer located in the mucosa and precancerous lesions less than 20mm in size, which can be resected completely. This method is safe, entails less complications and is especially suitable for the old and weak patients.

摘要

作者收集了14例位于黏膜层的早期胃癌及癌前病变病例,均采用内镜下黏膜切除术进行切除。这些病变如下:6例为早期胃癌(IIc型:4例;IIa型:2例);3例为重度不典型增生;5例为山田I型腺瘤。所有病变大小均小于20mm。4例早期胃癌完全切除。2例切除不完全,但在内镜下黏膜切除术后1个月进行了根治性胃切除术。3例重度不典型增生均完全切除。但其中2例接受了二次切除。5例腺瘤也完全切除。内镜下完全切除的标准参照日本文献报道。所有病例均随访4 - 41个月;内镜及组织学检查显示无残留及复发癌细胞。完全切除率为85.7%(12/14)。结果表明,内镜下黏膜切除术可应用于位于黏膜层、大小小于20mm且可完全切除的早期胃癌及癌前病变患者。该方法安全,并发症少,尤其适用于年老体弱患者。

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