针对早期巴雷特瘤的完整环内镜下膜剖析
Douglas Motomura1, Robert Bechara1
1Department of Medicine, Division of Gastroenterology, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
Gastrointestinal endoscopy
|October 7, 2023
概括
周围内镜下粘膜剖析 (ESD) 为治疗晚期食道瘤提供了一个成功的内镜替代方案,特别是在巴雷特食道病例中. 虽然有效,但需要仔细考虑收缩风险.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 在瘤学瘤学.
背景情况:
- 在西方国家,内镜下粘膜切割 (ESD) 越来越多地用于食道瘤.
- 在北美,食道癌常常由巴雷特食道引起.
- 周围ESD为晚期瘤提供了食道切除术的内镜替代方案.
研究的目的:
- 在北美中心呈现完整周围食道ESD的经验.
- 评估这项技术对巴雷特瘤的可行性和结果.
主要方法:
- 分析了一组11名患者,他们在2016年10月至2023年1月期间接受了100%的周围食道ESD.
- 收集的数据包括人口统计,程序细节和病变特征.
- 区块切除是标准的程序方法.
主要成果:
- 所有11项手术在技术上都取得了成功,其中包括阻断切除.
- 82%的患者实现了R0切除 (明显的边缘).
- 18%的人患有耐火性狭窄性,通过内镜进行管理;64%的人患有腺癌,其中86%的人从初始活检中升级.
结论:
- 周围ESD是一种可行的治疗选择,用于多聚焦性失塑性巴雷特食道.
- 该程序显示了高的成功率和低的不良事件发生率.
- 术后狭窄风险需要进一步调查最佳预防措施.
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