内镜下精准肌层剥离术治疗早期胃癌伴黏膜下层重度纤维化的临床价值初探（含视频）

Clinical value of endoscopic precise muscular dissection for early gastric cancer with submucosal severe fibrosis (with video)

摘要:

2018年5月—2020年8月，采用内镜下精准肌层剥离术（endoscopic precise muscular dissection，EPMD）对3例伴黏膜下层重度纤维化的早期胃癌患者进行了治疗。3例病变均一次性完整切除，标本无破损，标本长径2.0～5.7 cm，纤维化直径0.5～0.8 cm，手术时间30～70 min。1例术中穿孔，1例术后发热，无迟发性穿孔及出血发生。2例为治愈性切除，随访期内未见明显复发及转移；另一例为非治愈性切除，内科保守治疗，随访期内无复发转移。以上初步结果提示，EPMD可用于早期胃癌伴黏膜下层严重纤维化的治疗，但安全性和有效性尚需增加样本量进一步临床观察。

Abstract:

A total of three early gastric cancers (EGC)patients with submucosal severe fibrosis were successfully treated by endoscopic precise muscular dissection (EPMD) from May 2018 to August 2020.All the three lesions were en bloc resection and specimens were not damaged. The maximum diameter of specimens and fibrosis areas were 2.0-5.7 cm and 0.5-0.8 cm, respectively. The operation time was from 30 to 70 mins. Intraoperative perforation occurred in one case, post-operation fever cccured in one case, and no delayed perforation or bleeding occured. Two cases were cured resection and one case was non-cured resection without additional treatment. No recurrence or metastasis was observed during follow-up period.According to primary results, EPMD can be used for EGC with submucosal severe fibrosis, but the safety and effectiveness need clinical validation with more samples.