摘要
目的:探讨内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗下咽早期癌及癌前病变的有效性及安全性。方法:回顾性分析2015年12月—2019年5月在四川省肿瘤医院接受ESD的23例下咽早期癌及癌前病变患者的临床资料。结果:23例患者共30处病灶纳入研究,患者均为男性,平均年龄60.3岁(47~72岁)。23例患者中,13例伴同时性食管癌,3例伴异时性食管癌,7例伴同时性食管高级别上皮内瘤变。患者均成功完成ESD,平均手术时间74 min,整块切除率100%。术后病理提示21处为高级别上皮内瘤变、8处为黏膜内癌、1处为黏膜下深浸润癌。水平切缘阳性2例,垂直切缘阳性1例,治愈性切除率90%。术中及术后无严重出血、穿孔、呼吸困难等并发症。结论:ESD治疗下咽早期癌及癌前病变安全可行,值得在临床中推广应用。
Objective To evaluate the efficacy and safety of endoscopic submucosal dissection(ESD)for early hypopharyngeal carcinoma and precancerous lesions.Methods Data of 23 patients with early hypopharyngeal carcinoma and precancerous lesions who underwent ESD in Sichuan Cancer Hospital from December 2015 to May 2019 were analyzed.Results A total of 23 patients with 30 lesions were enrolled in the study.All patients were male,with mean age of 60.3 years(ranged 47-72).Of the 23 patients,13 had synchronous esophageal cancer,3 had metachronous esophageal cancer,and 7 high-grade intraepithelial neoplasia(HGIN)of the esophagus.The mean procedure time was 74 minutes.The en bloc resection rate was 100%.Pathological results revealed that 21 lesions were HGIN,8 lesions were intramucosal carcinoma and 1 lesion had tumor invasion of the submucosa.Two patients had positive horizontal margin and 1 patient had positive vertical margin.The curative resection rate was 90%.No bleeding,perforation or dyspnea occurred during or after ESD.Conclusions ESD is safe and effective for early hypopharyngeal cancer and precancerous lesions.
作者
赵锐
包郁
周凌霄
张真铭
刘武松
黄洁
Zhao Rui;Bao Yu;Zhou Lingxiao;Zhang Zhenming;Liu Wusong;Huang Jie(Department of Endoscopy Center,Sichuan Cancer Hospital,The Affiliated Cancer Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,China)
出处
《中华消化内镜杂志》
CSCD
北大核心
2020年第7期495-498,共4页
Chinese Journal of Digestive Endoscopy
基金
国家重点研发计划(2016YFC1303601)。
关键词
下咽肿瘤
鼻咽癌
内镜黏膜下剥离术
Hypopharyngeal neoplasms
Nasopharyngeal carcinoma
Endoscopic submucosal dissection
