摘要
Recent advances in techniques of therapeutic endoscopy for stomach neoplasms are rapidly achieved. One of the major topics in this field is endoscopic submucosal dissection （ESD）. ESD is a new endoscopic technique using cutting devices to remove the tumor by the following three steps： injecting fluid into the submucosa to elevate the tumor from the muscle layer, pre-cutting the surrounding mucosa of the tumor, and dissecting the connective tissue of the submucosa beneath the tumor. So the tumors are resectable in an en bloc fashion, regardless of the size, shape, coexisting ulcer, and location. Indication for ESD is strictly confined by two aspects： the possibility of nodal metastases and technical difficulty, which depends on the operators. Although long-term outcome data are still lacking, short-term outcomes of ESD are extremely favourable and laparotomy with gastrectomy is replaced with ESD in some parts of therapeutic strategy for early gastric cancer.
在为胃瘤的治疗学的内视镜检查法的技术的最近的进展很快被完成。这块地里的主要话题之一是内视镜的粘膜下层解剖(ESD ) 。ESD 是用切设备由下列三步移开肿瘤的一种新内视镜的技术：把液体注入粘膜下层从肌肉层提高肿瘤， pre-cutting 包围肿瘤的粘膜，并且把在肿瘤下面的粘膜下层的结缔组织。肿瘤因此是以一种整块方式能的将切除，不管尺寸，形状，共存的溃疡，和地点。为 ESD 的指示被二个方面严格地限制：节的转移和技术困难的可能性，它取决于操作员。尽管长期的结果数据仍然正在缺乏， ESD 的短期的结果是极其赞成的，有胃切除术的剖腹术为早胃的癌症在治疗学的策略的一些部分被 ESD 代替。
