体外磁牵引辅助内镜黏膜下剥离术的临床应用

Clinical application of magnetic anchor⁃guided endoscopic submucosal dissection

摘要:

目的 评估体外磁牵引辅助内镜黏膜下剥离术（magnetic anchor⁃guided endoscopic submucosal dissection，MAG⁃ESD）的可行性及有效性。方法 收集2020年3月—2022年10月于西安交通大学第一附属医院行MAG⁃ESD的不同部位消化道肿瘤患者36例。观察分析牵引成功率、病变完整切除率、牵引时间、手术时间、并发症发生率。结果 36例患者中，胃部病变9例，十二指肠病变2例，盲肠6例，结直肠19例。35例（97.2%）成功进行磁牵引及病变完整切除，无出血、穿孔等并发症发生。磁牵引用时4.0（2.0~9.5）min，手术用时36（16~82）min。结论 MAG⁃ESD治疗不同部位消化道肿瘤牵引成功率及完整切除率高，可缩短手术时间，是一种有效、可行的磁牵引辅助内镜下治疗技术，对于黏膜下剥离困难的病变可采用MAG⁃ESD。

Abstract:

Objective To evaluate the feasibility and effectiveness of magnetic anchor-guided endoscopic submucosal dissection (MAG-ESD). Methods A total of 36 patients with gastrointestinal tumors at different sites who underwent MAG-ESD in the First Affiliated Hospital of Xi''an Jiaotong University from March 2020 to October 2022 were enrolled. The anchor success rate, en bloc resection rate, the anchor time, the procedure time, and the complication incidence were observed and analyzed. Results Among the 36 patients, there were 9 lesions in stomach, 2 in duodenum, 6 in cecum and 19 in colorectum. Thirty-five (97.2%) patients successfully underwent magnetic anchor, and en bloc resection of lesions were completed. No adverse events such as bleeding or perforation occurred. The anchor time and procedure time was 4.0 (2.0-9.5) min and 36 (16-82) min, respectively. Conclusion MAG-ESD is feasible and effective for gastrointestinal tumors at different sites, with a high anchor success rate and en bloc resection rate, and shorter operation time, especially for difficult submucosal dissection.