摘要
目的探讨内镜黏膜下剥离术（ESD）治疗上消化道神经内分泌肿瘤的安全性及其疗效。方法采用ESD方法对19例上消化道神经内分泌肿瘤进行治疗，术后标本送病理检查，记录不良反应发生情况及疗效，随访肿瘤复发及转移情况。结果肿瘤直径0．4～1．5cm，平均0．9cm，均一次性完整剥离切除，ESD手术时间（自黏膜下注射至完整剥离病变）15—50min，平均20min，无严重出血及穿孔发生。术后18例病理诊断为神经内分泌瘤，其中G1级16例、G2级2例，基底和切缘均未见病变累及；另1例病理显示有浸润性生长倾向，诊断神经内分泌癌（G3级），行外科扩大切除，术后病理未见肿瘤组织残留，无淋巴结转移。平均随访28个月，无一例出现肿瘤复发和转移。结论ESD治疗上消化道神经内分泌肿瘤具有较好的安全性和疗效，值得在临床上推广应用。
Objective To investigate the therapeutic effect and safety of endoscopic submucosal dis- section （ESD） for upper gastrointestinal neuroendocrine neoplasms. Methods A total of 19 lesions diag- nosed as neuroendocrine neoplasm were treated by ESD. Pathological diagnosis was performed. Adverse even- tss were recorded. Patients were followed up for recurrence and metastasis. Results Lesions, 0. 4-1.5 cm （mean 0, 9 cm） in diameter, were all resected at one ESD procedure. The operation time was 15-50 min （mean 20 min）. No mass bleeding or perforation occurred. 18 cases were histologically diagnosed as neuro- endocrine tumors, with 16 as G1 and 2 as G2. One lesion was confirmed as G3 nenroendocrine carcinoma and the patient was referred for extensive surgery. All resected samples were free of residual tumor cell in the lateral and basal margins. Postoperative bleeding occurred in one case and was controlled endoseopically. No recurrence was detected during a mean follow-up of 28 months. Conclusion ESD, as a novel procedure for the treatment of the upper gastrointestinal neuroendocrine neoplasm, is safe and efficacious in clinic.
出处
《中华消化内镜杂志》
2012年第12期679-683,共5页
Chinese Journal of Digestive Endoscopy
基金
基金项目：国家自然科学基金项目（11071046）
关键词
消化道
神经内分泌肿瘤
内镜黏膜下剥离术
Digestive tract
Neuroendocrine neoplasm
Endoscopic submucosal dissection
作者简介
王小云（复旦大学在读博士）
通信作者：徐美东，Email：xumeidong@yahoo．com．cn
