论文部分内容阅读
目的 探讨内镜套帽法切除食管早期癌及癌前病变的应用价值。方法 采用套帽法切除食管早期癌及癌前病变 5 7例 ,其中食管早期癌 33例 ,癌前病变 2 4例 ;全组术前和术后均经病理证实。结果 5 7例中完全切除 4 8例 (84 .2 % ) ,不完全切除 9例中 1例改手术治疗 ,1例放射治疗 ,余行微波或氩离子凝固治疗 ;重度不典型增生灶 2 1例中 ,术后病理灶性癌变 6例 (2 8.6 % ) ;中度不典型增生灶 10例 ,术后重度不典型增生 2例 (2 0 .0 % ) ,灶性癌变 1例(10 .0 % ) ;1例术中出血 ,无穿孔、狭窄发生 ;随访 5年以上 12例 ,>3～ 5年 11例 ,1～ 3年 2 3例 ,不足 1年 11例 ,1例术后复发 ,非癌死亡 3例。结论 套帽法完全切除率较高 ,操作较简单 ,优于其他方法 ;病灶显示及切除技巧是影响完全切除的主要因素 ;中度不典型增生短期复查无好转和重度不典型增生 ,应采用内镜治疗 ;内镜黏膜切除治疗在食管癌防治策略中具有重要价值和意义
Objective To investigate the value of endoscopic caps and caps in resection of early esophageal cancer and precancerous lesions. Methods A total of 57 cases of early esophageal cancer and precancerous lesions were resected by the method of sleeve cap, 33 cases of early esophageal cancer and 24 cases of precancerous lesion were confirmed by pathological examination before and after operation. Results Of the 57 cases, 48 cases (84.2%) were completely resected, one case was not surgically removed, one case was treated by radiotherapy, the other was microwave or argon plasma coagulation. The severe atypical hyperplasia In our study, there were 6 cases (26.6%) with postoperative pathological canceration, 10 cases with moderate dysplasia, 2 cases with severe atypical hyperplasia (20.0%) and 1 case of focal carcinogenesis (10 cases). 0%); 1 case of intraoperative bleeding, no perforation, stenosis; follow-up of more than 5 years in 12 cases,> 3 to 5 years in 11 cases, 1 to 3 years in 23 cases, less than 1 year in 11 cases, 1 case of recurrence , 3 cases of non-cancer death. Conclusion The results showed that the rate of complete resection was higher than that of other methods. The indication of lesion and the technique of resection were the main factors affecting the complete resection. The moderate dysplasia and short-term follow-up showed no improvement and severe dysplasia. Mirror treatment; endoscopic mucosal resection in the prevention and treatment of esophageal cancer strategy has an important value and significance