ESD是治疗食管病变的新方法,不仅能完整切除较大的病变,还能提供完整的病理学诊断资料。【关键词】内镜黏膜下剥离术;内窥镜外科手术;食管结果结论Endoscopic Submucosal Dissection for Esophageal LesionsZHOU Ping-hong Y AO Li-qingMA Li-li CHEN W ei-feng XU Mei-dong ZHONG Y un-shi ZHANG Y i-qun QIN Xin-yuEndoscopicCenter, Zhongshan HospitalFudan University,Shanghai,200032,China[Abstract]Objective: Toapproachthe clinical valueofendoscopicsubmucosal dissection (ESD) foresophageal lesions.Method: ESDwascarried outwith theneedleknifeas following: (1)Injectingfluid intothesubmucosatoelevatethelesion fromthemusclelayer,(2)pre-cuttingthesurroundingmucosaof thelesion,(3) dissectingtheconnectivetissueofthesubmucosa beneaththelesion.Results: The20 casesesophageal lesions wererangedfrom 0.5to 7.0cm (meansize2.6 cm) ,18ofthem weresuccessfully resectedwith ESD andenblocresection ratewas 90.0%(18/20).All18lesions wereresected with lateral and basal resection margins freeoftumor.ThemeanESD proceduretime(from fluidinjectionto completedissection)was 45minutes(rangedfrom 15to 150 minutes).Minorbleeding occurred in allofthelesions;1 patient hadmassivehemorrhagewhichcouldnot becontrolled with gastroscopeandrequired balloon compressionduring ESD,the bleeding ratewas 5.0% (1/20). Subcutaneous emphysema occurred in onecaseduring the dissection ofthe esophageal cyst,and recovered afterseveral days' conservativetreatment.Theperforation rateof ESDwas 5.0%(1/20). 11caseswere followedupafter ESD,with confirmed healingoftheartificial ulcer with no residueorrecurrence.Conclusion: ESDis anovel endoscopicsurgical procedureto treat esophageal lesions,which makesit possibleto resect wholelargelesion and providepathological informationabout thewholelesion.[Key words]Endoscopicsubmucosal dissection (ESD) ;Endoscopicsurgical procedure;Esophagus通讯作者:姚礼庆:@ z