The study on safety of endoscopic submucosal dissection in elderly patients with lesions of gastroesophageal mucosa
10.3760/cma.j.issn.0254-9026.2009.09.010
- VernacularTitle:老年人胃食管黏膜病变内镜黏膜下剥离术的安全性探讨
- Author:
Liping YE
;
Xinli MAO
;
Xia CHEN
;
Jiya CHEN
- Publication Type:Journal Article
- Keywords:
Endoscopy,gastrointestinal;
Gastrointestinal neoplasms;
Leiomyoma
- From:
Chinese Journal of Geriatrics
2009;28(9):737-739
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety of endoscopic suhmucosal dissection (ESD) in elderly patients with lesions of gastroesophageal mucosa. Methods Thirty-six elderly patients with flat elevation lesion of gastroesophageal mucosa were studied from July 2007 to May 2008. There were 14 cases with dysplasia, 9 cases with early carcinoma and 13 cases with leiomyoma confirmed by pathologic biopsy and endoscopic ultrasonography. All the patients were treated under consciousness condition, and the focus of lesion were completely resected with improved hook knife, IT knife and electrocoagulation or electro-cutting technique. The wound surface was managed with noradrenaline added in ice physiological saline, argon beam coagulator and metal clips. After operation, they were treated by abrosia, acid suppression and mucosa protection. The conditions of wound healing and residual lesions were reexamined four weeks after operation. Results Among the 36 patients (19 males and 17 females), there were 29 patients(80.6%) with complete focus ablation by ESD and 7 patients (19.4%) with resection by snare. Three cases (8.3%) of perforation occurred during operation and the perforations were treated with metal clips. After inserting stomach tube for fasting and anti-infection treatment for 5-7 days, all the three cases were recovered. One case(2.8%)had hematemesis 2 hours after operation and bleeding was stopped by endoscopic metal clip. Conclusions ESD is a safe and effective therapeutic tool in elderly patients with lesions of gastroesophageal mucosa.
