切换至 "中华医学电子期刊资源库"

中华胃食管反流病电子杂志 ›› 2017, Vol. 04 ›› Issue (04) : 161 -164. doi: 10.3877/cma.j.issn.1674-6899.2017.04.005

所属专题: 文献

论著

内镜下黏膜套扎切除术对肠化生型Barrett食管的疗效
贺欢1, 孔文洁1, 高峰1,()   
  1. 1. 830001 乌鲁木齐,新疆维吾尔自治区人民医院消化内科
  • 收稿日期:2017-10-12 出版日期:2017-11-15
  • 通信作者: 高峰

The effect of endoscopic mucosal resection with ligation for intestinal metaplasia of Barrett′s esophagus

Huan He1, Wenjie Kong1, Feng Gao1,()   

  1. 1. Department of Gastroenterology, Xinjiang Uygur Autonomous Region People′s Hospital, Urumqi 830001, China
  • Received:2017-10-12 Published:2017-11-15
  • Corresponding author: Feng Gao
  • About author:
    Corresponding author: Gao Feng, Email:
引用本文:

贺欢, 孔文洁, 高峰. 内镜下黏膜套扎切除术对肠化生型Barrett食管的疗效[J]. 中华胃食管反流病电子杂志, 2017, 04(04): 161-164.

Huan He, Wenjie Kong, Feng Gao. The effect of endoscopic mucosal resection with ligation for intestinal metaplasia of Barrett′s esophagus[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2017, 04(04): 161-164.

目的

探讨内镜下黏膜套扎切除术(EMRL)对肠化生型Barrett食管的有效性及安全性。

方法

回顾性分析2014年4月至2016年4月,新疆维吾尔自治区人民医院消化内科经胃镜检查且病理证实为肠化生型Barrett食管,并行EMRL的45例患者病案资料,观察其临床症状特点,记录术中及术后发生的并发症及处理情况,术后6个月复查胃镜,评价切除效果。

结果

45例患者主要临床表现为上腹部不适、胸骨后不适、反酸等其它胃食管反流症状,其中17例(37.8%)患者无胃食管反流症状;所有患者病灶均一次性完整切除,相关并发症包括胸骨后不适5例,上腹部不适3例,食管穿孔1例;术后6个月复查胃镜发现1例复发。

结论

内镜下黏膜套扎切除术对肠化生型Barrett食管安全有效,但仍需多中心、大样本的随机对照研究。

Objective

To evaluate the efficacy and safety of Endoscopic mucosal resection with ligation(EMRL)for the treatment of Barrett′s esophagus(intestinal metaplasia).

Methods

Retrospective analysis of Gastroenterology from April 2014 to April 2016 endoscopy and pathology confirmed Barrett esophagus(intestinal type)45 patients with EMRL.To observe the clinical characteristics of patients, The rates of complications and following treatments were recorded, review endoscopy after 6 months to evaluate the curative effect.

Results

The main symptoms of 45 patients were upper abdominal discomfort, posterior sternal discomfort, acid reflux, 17 patients(37.8%)patients without GRED symptoms.All the lesions were resected in one time.The complications included sternal discomfort in 5 cases, upper abdominal discomfort in 3 cases and esophageal perforation in 1 case.

Conclusion

Endoscopic mucosal resection with ligation is safe and effective in the treatment of Barrett ′s esophagus(intestinal metaplasia). However, multicenter, large-scale randomized controlled studies are still needed.

图1 内镜下黏膜套扎切除术治疗
[1]
中华医学会消化病学分会.Barrett食管诊治共识(2011修订版,重庆)[J].中华消化内镜杂志,2011,28(8):421-422.
[2]
张亚飞,王鹏,房殿春.Barrrett食管的病理诊断[J].胃肠病学,2010,15(10):635-638.
[3]
中国巴雷特食管及其早期腺癌筛查与诊治共识(2017万宁).国家消化系统疾病临床医学研究中心,中华医学会消化内镜学分会,中国医师协会消化医师分会[J].中国医刊,2017,52(9):8-19.
[4]
Spechler SJ, Sharma P, Souza RF,et al.American Gastroenterological Association medical position statement on the management of Barrett′s esophagus[J].Gastroenterology,2011,140(3):1084-1091.
[5]
Hamilton SR, Smith RR.The relationship between columnar epithelial dysplasia and invasive adenocarcinoma arising in Barrett′s esophagus[J].Am J Clin Pathol,1987,87(3):301-312.
[6]
Desai TK, Krishnan K, Samala N,et al.The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett′s oesophagus:a metaanalysis[J].Gut,2012,61(7):970-976.
[7]
Falk GW.Barrett′s esophagus[J].Gastroenterology,2002,122(6):1569-1591.
[8]
Salemme M, Villanacci V, Cengia G,et al.Intestinal metaplasia in Barrett′s oesophagus:An essential factor to predict the risk of dysplasia and cancer development[J].Dig Liver Dis,2016,48(2):144-147.
[9]
Bhat S, Coleman HG, Yousef F,et al.Risk of malignant progression in Barrett′s esophagus patients:results from a large population-based study[J].J Natl Cancer Inst,2011,103(13):1049-1057.
[10]
Wilson KT, Fu S, Ramanujam KS,et al.Increased expression of inducible nitric oxide synthase and cyclooxygenase-2 in Barrett′s esophagus and associated adenocarcinomas[J].Cancer Res,1998,58(14):2929-293.
[11]
Eloubeidi MA, Mason AC, Desmond RA,et al.Temporal trends(1973-1997)in survival of patients with esophageal adenocarcinoma in the United States:a glimmer of hope?[J].Am J Gasrtoenterol,2003,98(7):1627-1633.
[12]
Gupta N, Gaddam S, Wani SB,et al.Longer inspection time is associated with increased detection of high-grade dysplasia and esophageal adenocarcinoma in Barrett′s esophagus[J].Gastrointest Endosc,2012,76(3):531-538.
[13]
Mannath J, Subramanian V, Hawkey CJ,et al.Narrow band imaging for characterization of high grade dysplasia and specialized intestinal metaplasia in Barrett′s esophagus:a meta-analysis[J].Endoscopy,2010,42(5):351-359.
[14]
施宏,蒋圣军,王永光,等.套扎辅助内镜下黏膜切除术治疗Barrett食管的前瞻性研究[J/CD].中华临床医师杂志电子版,2010,4(4):35-37.
[15]
Wani S, Sayana H, Sharma P.Endoscopiceradication of Barrett′s esophagus[J].Gastrointest Endosc,2010,71(1):147-166.
[16]
Saito I, Tsuji Y, Sakaguchi Y,et al. Complications related to gastric endoscopic submucosal dissection and their managements[J].Clin Endosc, 2014,47(5):398-403.
[17]
中华医学会消化病学分会.2014年中国胃食管反流病专家共识意见[J].中华消化杂志,2014(10):155-168.
[18]
Fitzgerald RC, di Pietro M, Ragunath K,et al.British Society of Gastroenterology guidelines on the diagnosis and management of Barrett′s oesophagus[J].Gut,2014,63(1):7-42.
[19]
Wang KK, Sampliner RE,Practice Parameters Committee of the American College of Gastroenterology..Updated guidelines 2008 for the diagnosis,surveillance and therapy of Barrett′s esophagus[J].Am J Gastroenterol,2008,103(3):788-797.
[1] 李颖, 张若蹊, 刘婷, 刘殿刚. Barrett食管伴滑动性食管裂孔疝腹腔镜治疗疗效观察[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(06): 663-667.
[2] 杨克利, 丁岩军, 季万胜. 胆汁酸在Barrett食管和食管腺癌发病中的作用[J]. 中华消化病与影像杂志(电子版), 2022, 12(03): 154-157.
[3] 虎金朋, 周燕, 莫丽蓉, 郑路路, 杨金芳, 张雪, 牛敏, 杨珍, 张玲, 白飞虎. 内镜下射频消融术在消化系统疾病中的应用[J]. 中华消化病与影像杂志(电子版), 2019, 09(02): 82-85.
[4] 孔洋洋, 刘立新. 胃食管反流病患者幽门螺杆菌感染率的Meta分析[J]. 中华消化病与影像杂志(电子版), 2017, 07(05): 205-210.
[5] 王军丽, 张文平. 细胞外囊泡在Barrett食管及食管腺癌诊断和发病中的研究进展[J]. 中华诊断学电子杂志, 2021, 09(03): 207-210.
[6] 石蕾, 王薇. 老年胃食管反流病的诊治[J]. 中华诊断学电子杂志, 2017, 05(02): 73-79.
[7] 冯建聪, 柴宁莉, 令狐恩强. 消化内镜超级微创手术在食管肿瘤性疾病中的应用[J]. 中华胃肠内镜电子杂志, 2022, 09(01): 45-50.
[8] 张帅, 刘迎娣, 令狐恩强. Barrett食管的内镜下治疗进展[J]. 中华胃肠内镜电子杂志, 2021, 08(03): 125-129.
[9] 年媛媛, 王学勤, 江振宇, 陈洪锁, 贾东武, 张玉萍, 孟宪梅. Barrett食管、反流性食管炎和非糜烂性胃食管反流病的反流物特点[J]. 中华胃肠内镜电子杂志, 2020, 07(04): 198-201.
[10] 刘亚萍, 曹运华, 刘斌, 杨佳, 李欢, 王东. 内镜下氩离子凝固术治疗Barrett食管的研究进展[J]. 中华胃食管反流病电子杂志, 2020, 07(01): 60-63.
[11] 米亚赛尔·力提甫, 美丽克扎提·安扎尔, 艾合买江·库尔班江. 氩离子凝固术在Barrett食管中治疗效果及安全性分析[J]. 中华胃食管反流病电子杂志, 2018, 05(04): 167-171.
[12] 金恬, 余晓云. Barrett食管的诊断监测及治疗[J]. 中华胃食管反流病电子杂志, 2018, 05(03): 125-129.
[13] 吾布力卡斯木·吾拉木, 巴突尔·艾克木, 买买提·依斯热依力, 刘晓勇, 克力木·阿不都热依木. 不同亚型胃食管反流病食管黏膜下层炎症因子变化特点研究[J]. 中华胃食管反流病电子杂志, 2018, 05(03): 97-101.
[14] 美丽克扎提·安扎尔, 米热阿依·阿不都哈的尔, 高峰. Barrett食管、糜烂性食管炎和非糜烂性反流病食管酸暴露及食管动力学分析[J]. 中华胃食管反流病电子杂志, 2018, 05(02): 49-52.
[15] 赫晓磊, 黄晓玲, 高峰. 氩气凝固术联合艾司奥美拉唑肠溶片治疗206例Barrett食管患者的疗效观察[J]. 中华胃食管反流病电子杂志, 2017, 04(02): 63-65.
阅读次数
全文


摘要