The therapeutic effect of endoscopic submucosal dissection and risk factors of bleeding
10.3760/cma.j.issn.1007-5232.2012.10.003
- VernacularTitle:内镜黏膜下剥离术的疗效及出血危险因素分析
- Author:
Xiaojia HOU
;
Zhaoshen LI
;
Xingang SHI
;
Feng LIU
;
Jie CHEN
;
Yiqi DU
- Publication Type:Journal Article
- Keywords:
Endoscopes;
Endoscopic submucosal dissection;
Efficiency;
Hemorrhage;
Risk factors
- From:
Chinese Journal of Digestive Endoscopy
2012;29(10):549-553
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for digestive tract mucosal lesions,and risk factor of complications.Methods The data of 154 consecutive patients who underwent ESD for superficial digestive tract mucosal lesions were analyzed prospectively for therapeutic effect and rate of complications.Risk factors for bleeding was analyzed.Results The enbloc resection rate in 145 completed ESD procedures was 100.0％.Histologically,complete resection rate was 99.3％.ESD was not completed in 9 patients due to bleeding ( n =5) and perforation ( n =4).Acute massive bleeding occurred in 6 patients (6/154,3.9％),mild bleeding in 5 (3.2％),delayed bleeding in l (0.6％ ),perforation in 4 (2.6％ ) and post-ESD stenosis in 1 (0.6％ ).All complications were cured.The post-ESD ulcer-healing was achieved in 100％ at 8 weeks after treatment.During follow-up of 10.6months( ranged from 8 to 18 months),no residual or local recurrence was found.Statistic analysis showed independent risk factors for bleeding in ESD were lesion location (cardiac fundus),and lesion size.Conclusion ESD is an effective and safe procedure in treatment of digestive tract mucosal lesions.The complications of ESD are preventable and curable.Strictly controlling operation indications,individualized treatment and the proficient operation skills of physicians are the keys to success.
