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目的探讨内镜黏膜切除术(EMR)治疗上消化道肿瘤的应用价值。方法回顾性分析108例(126个病灶)内镜下行EMR治疗资料。结果 126个病灶中,直接用圈套器切除86个病灶,用透明帽切除40个病灶。病灶大小0.3cm×0.4cm～5.0cm×7.0cm,均为扁平病灶;92个病灶1次切除,34个病灶多次(>2次)分割切除;102个病灶取到病理组织,24个病灶未取到;完全切除118个,完全切除率93.7%。内镜分型:隆起型(Ⅰ型)64个,其中亚蒂型(Isp)45个,无蒂型(Is)19个;平坦型(Ⅱ型)62个,其中平坦隆起型(Ⅱa)34个,平坦隆起+平坦凹陷型(Ⅱa+Ⅱc)10个,表面平坦型(Ⅱb)18个。组织学分型早期癌4个,重度不典型增生14个,中度不典型增生59个,单纯腺瘤26个,非腺瘤性息肉23个。其中发生大出血1例,有18例切除后出现少量渗血,无一例穿孔。结论内镜下黏膜切除术简单、安全。
Objective To investigate the value of endoscopic mucosal resection (EMR) in the treatment of upper gastrointestinal cancer. Methods Retrospective analysis of 108 cases (126 lesions) endoscopic EMR treatment data. Results Among 126 lesions, 86 lesions were excised directly with a snare and 40 lesions were removed with a transparent cap. The size of the lesion was 0.3cm × 0.4cm ~ 5.0cm × 7.0cm, all of them were flat lesions. 92 lesions were excised one time and 34 lesions were divided (> 2 times). 102 lesions were obtained from pathological tissues and 24 lesions Not taken; totally resected 118, the complete resection rate of 93.7%. Endoscopic type: There were 64 bulging type (type I), of which 45 were Isti type and 19 were Isometric type, and 62 were type II type (Ⅱa) 34 There were 10 flat and flat depressed (Ⅱa + Ⅱc) and 18 flattened (Ⅱb). There were 4 early histological types, 14 severe atypical hyperplasia, 59 moderate atypical hyperplasia, 26 pure adenoma and 23 non-adenomatous polyps. One case of major bleeding occurred, there were 18 cases of a small amount of bleeding after resection, no case of perforation. Conclusion Endoscopic mucosal resection is simple and safe.