本文關鍵詞： 黏膜病變 胃食管連接部 胃鏡黏膜下剝離術 胃鏡檢查　出處：《中華實用診斷與治療雜志》2016年11期 　論文類型：期刊論文

【摘要】：目的探討胃鏡黏膜下剝離術(endoscopic submucosal dissection,ESD)治療胃食管連接部黏膜病變的療效及安全性。方法回顧性分析30例胃食管連接部黏膜病變患者臨床資料,分析病變特點及ESD治療切除率和手術時間,隨訪觀察術后并發(fā)癥和復發(fā)情況。結果患者胃食管連接部黏膜病變直徑(30±15)mm,ESD治療完整切除率為100%,手術時間(45±16)min;術后1例有少量胃管內出血,未發(fā)生穿孔等并發(fā)癥;組織病理確診黏膜慢性炎癥8例,萎縮性胃炎3例,增生性息肉6例,低級別上皮內瘤變9例,高級別上皮內瘤變3例,腺癌1例;平均隨訪18個月,無復發(fā)。結論 ESD治療胃食管連接部黏膜病變的完整切除率高,安全。
[Abstract]:Objective to investigate endoscopic submucosal dissection in submucosal dissection. Methods the clinical data of 30 patients with gastroesophageal junction mucosal lesions were retrospectively analyzed. The characteristics of the lesions, the resection rate and the operation time of ESD were analyzed, and the postoperative complications and recurrence were observed. Results the diameter of mucosal lesions in the gastroesophageal junction was 30 鹵15mm. The complete resection rate of ESD was 100 and the operation time was 45 鹵16 minutes. There was a small amount of intragastric hemorrhage in 1 case, and no complications such as perforation occurred. 8 cases of chronic inflammation of mucosa, 3 cases of atrophic gastritis, 6 cases of proliferative polyps, 9 cases of low grade intraepithelial neoplasia, 3 cases of high grade intraepithelial neoplasia and 1 case of adenocarcinoma were confirmed by histopathology. Conclusion the complete resection rate of ESD for gastroesophageal junction mucosal lesions is high and safe.
【作者單位】： 江陰市中醫(yī)院內鏡中心;復旦大學附屬中山醫(yī)院內鏡中心;
【基金】：國家自然科學基金(81370588)
【分類號】：R655.4
【正文快照】： 胃食管連接部是鱗狀上皮及柱狀上皮交匯處,為食管與胃結合部位,管腔狹窄且為銳性轉角,其特殊的解剖結構可增加術后并發(fā)癥發(fā)生率[1]。胃食管連接部病變臨床多采用開腹或腹腔鏡手術,但術后可引起胃食管反流等。隨著胃鏡技術發(fā)展,臨床對病變局限于上皮內、且無淋巴結轉移的癌前病

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