摘要
目的研究新型辅助技术圈套器联合棉线在内镜黏膜下剥离上消化道早癌病变中的应用研究。方法回顾性研究2016年6月-2019年2月在该院内镜中心接受治疗的上消化道早癌患者40例,分为对照组和改良牵引组,每组各20例。对照组采用传统的内镜黏膜下剥离术(ESD),改良牵引组使用圈套器联合棉线牵引辅助行ESD,分别从手术完整切除率、手术时间、术中及术后并发症、术后平均住院天数等方面进行对比。结果术前两组患者在年龄、性别构成、肿瘤部位及直径等方面差异均无统计学意义(P>0.05)。两组上消化道早癌患者完整切除率为100%。对照组手术时间为(73.95±13.04)min,改良牵引组为(50.95±12.62)min,改良牵引组手术时间明显短于对照组,差异有统计学意义(t=4.74,P<0.01)。对照组有2例发生术中出血、2例术后发生迟发性出血及穿孔,均通过内镜下处理好转出院。对照组住院时间为(10.21±3.74)d,改良牵引组为(6.05±2.56)d,改良牵引组住院时间明显短于对照组,差异有统计学意义(t=9.15,P<0.01)。所有标本术后病理底切缘及侧切缘均为阴性。40例患者术后随访至截稿时均未复发,无术后食管胃狭窄等远期并发症。结论圈套器联合棉线牵引辅助装置能给ESD操作者提供良好的手术视野,在缩短手术时间的同时,降低并发症的发生风险,而且该装置组合简便,能作为ESD治疗黏膜病变过程中的一个有效辅助装置。
Objective To study the application of a new assisted technique snare in combination with cotton in treatment of early gastrointestinal digestive lesions under endoscopic submucosal dissection.Methods A retrospective study of 40 cases of upper gastrointestinal early cancer from June 2016 to February 2019 was conducted.The patients were divided into the control group and the modified traction group.The control group underwent traditional endoscopic submucosal dissection(ESD),while the modified traction group used a snare with cotton traction to assist with ESD,including complete resection rate,operative time,intraoperative and postoperative complications.The average number of hospital stays after surgery was compared.Results There were no significant differences in age,gender composition,tumor location and diameter between the two groups(P>0.05).The complete resection rate of 40 patients with upper gastrointestinal early cancer in the two groups was 100%.The operation time was(73.95±13.04)min,(50.95±12.62)min,and the operation time of the modified traction group was significantly shorter than that of the control group.The difference was statistically significant(t=4.74,P<0.01).In the control group,there were 2 cases of intraoperative hemorrhage,2 cases of delayed bleeding and perforation after operation,but all the patients were treated by endoscopic treatment and discharged.The hospital stays in the two groups were(10.21±3.74)d and(6.05±2.56)d,respectively.The hospital stay in the modified traction group was significantly shorter than that in the control group(t=9.15,P<0.01).All the specimens were negative for pathological bottom margin and lateral margin.Forty patients were followed up to the time of writing and did not relapse without long-term complications such as postoperative esophagogastric stricture.Conclusion The snare combined with the cotton traction aid can provide a good surgical field for ESD operators,reduce the risk of complications while shortening the operation time,and the device is simple and can be used as an effective treatment for ESD in the treatment of mucosal lesions assisting equipments.
作者
梁凤
王昌成
乔晓
韩成艳
杨炳银
陈倩倩
刘树青
Feng Liang;Chang-cheng Wang;Xiao Qiao;Cheng-yan Han;Bing-yin Yang;Qian-qian Chen;Shu-qing Liu(Department of Gastroenterology,the Affiliated Huai’an Hospital of Xuzhou Medical University(the Second People’s Hospital of Huai’an),Huai’an,Jiangsu 223000,China)
出处
《中国内镜杂志》
2020年第5期20-25,共6页
China Journal of Endoscopy
关键词
消化道早癌
圈套器
牵引
内镜黏膜下剥离术
early digestive tract cancer
snare
traction
endoscopic submucosal dissection
