内镜黏膜下剥离术治疗早期食管癌及食管癌前病变

研究内镜黏膜下剥离术（ESD）治疗早期食管癌及食管癌前病变的治疗价值。对25例早期食管癌及食管癌前病变在确定病变范围及浸润深度后行黏膜下剥离术。先超声内镜判断浸润深度及利用Lugol液染色确定病灶范围，后采用术中标记、粘膜下注射、边缘粘膜切开、剥离及创面处理等方法。结果显示，病灶完整切除，术中无穿孔、出血；术后3、6、12月常规随访，均无复发。1例术后3个月出现食管狭窄，给予扩张后狭窄缓解。结果表明，对早期食管癌及食管癌前病变，内镜黏膜下剥离术是一种安全的内镜下治疗方法。

Endoscopic Submucosal Dissection for Early Esophageal Cancer and Esophageal Precancerous Lesions

Objective The efficacy of endoscopic submucosal dissection （ESD） in the treatment of early esophageal cancer and esophageal precancerous lesions was studied. Methods 4 patients with early esophageal cancer and 21 patients with esophageal precancerous lesions were treated by ESD after confirming the lesion range and invasion depth. Endoscopic ultrasonography was used to measure the invasion depth and lugol＇s staining was applied in measuring lesion range. Intraoperative mapping, submucosal injection, marginal mucosa incision, split and wound treatment were utilized as well. Results All lesions were completely removed, and no perforation or bleeding occurred during the operation. In the third month one patient was found to have esophageal stenosis which was relieved after a dilation. To random visit the patients 3, 6 and 12 months after operation, there was no recurrence. Conclusion ESD is a safe way to treat early esophageal cancer and esophageal precancerous lesions.