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目的探讨多环黏膜切除术治疗早期食管癌及癌前病变的临床疗效。方法 2011年9月至2012年12月四川大学华西医院消化内科收治早期食管癌及癌前病变患者共47例,其中男26例、女21例,年龄58.80岁。所有患者均行内镜下多环黏膜切除术治疗。结果全组手术均成功,平均手术时间25.4 min,病灶平均直径2.4 cm。所有病变均一次性彻底切除,术中及术后无出血病例。术后1例患者出现气胸,保守治疗后痊愈。术后随访47例,随访时间12~26(18.0±2.4)月,全组均无复发。2例患者出现食管狭窄,其中1例行内镜下食管水囊扩张术后吞咽困难明显缓解。结论多环黏膜切除术治疗早期食管癌及癌前病变快速、操作简单,短期疗效较好,但对于直径>3 cm的病变存在术后食管狭窄的风险,仍需谨慎选择。
Objective To investigate the clinical efficacy of polycyclic mucosal resection in the treatment of early esophageal cancer and precancerous lesions. Methods From September 2011 to December 2012, 47 patients with early esophageal cancer and precancerous lesions were admitted to Department of Gastroenterology, West China Hospital of Sichuan University, including 26 males and 21 females, aged 58.80 years. All patients underwent endoscopic polyp mucosal resection. Results All the operations were successful, with an average operation time of 25.4 min and an average diameter of 2.4 cm. All lesions were completely removed one-time, intraoperative and postoperative no bleeding cases. One patient developed pneumothorax after surgery and recovered after conservative treatment. 47 cases were followed up for 12 to 26 months (18.0 ± 2.4) months, no recurrence was found in the whole group. Esophageal stenosis occurred in 2 patients. One patient underwent endoscopic esophageal hydrosalveolar dilatation, the dysphagia was significantly relieved. Conclusions Polycyclic mucosal resection for early esophageal cancer and precancerous lesions is rapid, simple and short-term curative effect is good, but the risk of postoperative esophageal stenosis in patients with diameter> 3 cm still need to be carefully selected.