Endoscopic submucosal dissection for early gastrointestinal cancer and precancerous lesions
- VernacularTitle:内镜黏膜下剥离术治疗消化道早期癌及癌前病变
- Author:
Zhongsheng LU
;
Enqiang LINGHU
;
Qiyang HUANG
;
Lihua PENG
;
Gang SUN
;
Hong DU
;
Xiangdong WANG
;
Jiangyun MENG
;
Hongbin WANG
;
Yunsheng YANG
- Publication Type:Journal Article
- Keywords:
Gastrointestinal neoplasms;
Endoscopic submucosal dissection;
Precancerous conditions
- From:
Chinese Journal of Digestive Endoscopy
2008;25(11):578-583
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the procedure,effect and complication of endoscopic submucosal dissection (ESD) in the management of early gastrointestinal tumors and precancerous lesions.MethodsESD was performed in 28 patients with 29 lesions of early cancer and precancerous lesions in esophagus,stomach,colon and rectum.First we made marks around the lesion 3-5 mm away from the margin with a needle knife or APC,then injected solution into submucosa to elevate the lesion,and cut the mucosa and submucusa along the margin with a needle knife or IT knife.The submucosa was carefully dissected until the lesions were completely removed with IT knife.Bleeding was stopped with thermocoagulation forceps,argon plasma coagulation or clip.The samples were collected for pathological examination.All patients were followed up with endoscopy as scheduled.ResultsOf the 29 lesinas,22 were en bloc resected,6 were piecemeal resccted,and 1 was partial removed.The resection rate of antral lesion was 100% (12/12),and that of lesions between angulus and cardia was 5/7,that of esophageal lesions was 3/5 and that of colorectal ncoplasmns was 2/5.Delayed bleeding occured in 1 patient.The mean operation time for the antral lesions was 48 minutes.Twenty patients were followed up for 1 to 12 months.No residue or recurrence of the lesions was found.ConclusionThe major advantage of ESD is that the resection area can be determined by the size and shape of the lesion,and resection can be achieved en bloc even in a large neoplasm.
