内镜黏膜下剥离术治疗30例早期胃癌

被引:6
作者
聂莉华
王新仁
谭细生
机构
[1] 丰城市人民医院消化内科
关键词
胃肿瘤; 早期; 内镜黏膜下剥离术;
D O I
暂无
中图分类号
R735.2 [胃肿瘤];
学科分类号
100112 [医学生物化学与分子生物学];
摘要
目的探讨内镜黏膜下剥离术(ESD)治疗早期胃癌的操作方法、疗效、并发症等。方法按照入选标准选取早期胃癌患者30例,内镜下明确病变边界,采用氩离子凝固或针刀在距病变边缘0.3~0.5cm处作环周点状凝固标记,再行黏膜下注射0.5~1.0mL注射液[配制比例:500mL生理盐水+200mg美蓝(4∶10 000)+50mg去甲肾上腺素(1∶10 000)],使病变完全抬起,在距离标记点约0.5cm处用针刀及IT刀环行切开黏膜至黏膜下层,用IT刀逐渐将黏膜剥离,部分病变回缩后用圈套器将病变黏膜完整圈套电凝切除。切除病变标本及时送病检。所有病例均按计划胃镜随访。结果 30例病变完整切除,2例出现术后迟发出血。胃窦病变平均手术耗时最短,为52min。20例随访1~12个月均未见病变残留或复发。结论 ESD可以根据病变的大小及形状确定切除范围,对较大病变可以整块切除。缺点是操作过程较复杂、技术难度较大。
引用
收藏
页码:67 / 69
页数:3
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