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目的:评估钛夹联合尼龙绳牵引辅助下内镜黏膜下剥离术(ESD)治疗早期胃角癌及癌前病变的应用价值及安全性。方法:以2018年1—12月在杭州市第一人民医院行ESD治疗的59例早期胃角癌及癌前病变患者为研究对象，采用随机数字表法随机分入常规ESD组(对照组，n＝28)和钛夹联合尼龙绳牵引组(试验组，n＝31)。比较两组患者的黏膜下补充注射次数、ESD手术时间、病灶面积、黏膜剥离时间、单位时间切除率、病灶完整切除率以及手术并发症等情况。结果:试验组黏膜下补充注射次数少于对照组[(2.3±1.1)次比(3.7±1.4)次，n t＝4.557，n P<0.001]；试验组的病灶面积和对照组相比差异无统计学意义[(12.7±2.6)cmn 2比(11.7±2.7)cmn 2，n t＝1.485，n P＝0.143]；试验组ESD手术时间[(72.4±24.7)min比(93.6±28.9)min，n t＝3.043，n P＝0.004]和黏膜剥离时间[(67.7±23.3)min比(88.2±28.3)min，n t＝3.054，n P＝0.003]短于对照组，单位时间切除率高于对照组[(20.2±3.2)mmn 2/min比(14.3±3.4)mmn 2/min，n t＝6.879，n P<0.001]。两组患者的一次性完整切除率均为100.0%。两组患者均未出现穿孔及术后出血等，试验组术中出血率低于对照组[19.4%(6/31)比35.7%(10/28),n χ2＝1.992，n P＝0.158]。n 结论:使用钛夹联合尼龙绳牵引辅助技术可降低胃角ESD的技术难度、缩短操作时间、降低术中出血可能，具有较好的应用价值。“,”Objective:To evaluate the efficacy and safety of clip-with-endoloop method during endoscopic submucosal dissection (ESD) in treatment of early gastric angle cancer and precancerous lesions.Methods:A total of 59 patients with early gastric angle cancer or precancerous lesions underwent ESD from January 2018 to December 2018 were randomly divided into the routine ESD group (n n=28) and the clip-with-endoloop group (n n=31). The frequency of supplementary submucosal injection, ESD procedure time, area of the resected specimen, dissection time, submucosal dissection speed, complete resection rate and complications were compared between the two groups.n Results:The frequency of supplementary submucosal injection in the clip-with-endoloop group was less than that in the routine ESD group (2.3±1.1 VS 3.7±1.4, n t=4.557, n P<0.001). There was no significant difference in the area of the resected specimen between the two groups (12.7±2.6 cmn 2 VS 11.7±2.7 cmn 2,t=1.485, n P=0.143). The ESD procedure time (72.4±24.7 min VS 93.6±28.9 min, n t=3.043, n P=0.004) and dissection time (67.7±23.3 min VS 88.2±28.3 min, n t=3.054, n P=0.003) in the clip-with-endoloop group were significantly shorter compared with those in the routine ESD group. The submucosal dissection speed in the clip-with-endoloop group was higher than that in the routine ESD group (20.2±3.2 mmn 2/min VS 14.3±3.4 mmn 2/min, n t=6.879, n P<0.001). The complete resection rate was 100.0% in the both groups. No perforation or postoperative bleeding occurred in the two groups. The incidence of intraoperative bleeding in the clip-with-endoloop group was lower than that in the routine ESD group [19.4% (6/31) VS 35.7% (10/28),n χ2=1.992, n P=0.158].n Conclusion:Clip-with-endoloop method makes ESD procedures easier and faster, with a lower possibility of intraoperative bleeding in treatment of early gastric angle cancer.