本文關(guān)鍵詞：消化道病變的內(nèi)鏡黏膜下剝離術(shù)（ESD）治療結(jié)果和并發(fā)癥的回顧性研究　出處：《東南大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 內(nèi)鏡黏膜下剝離術(shù)(ESD) 胃腸道(胃腸道)病變 殘留組織 病發(fā)癥 復(fù)發(fā)

【摘要】：背景：內(nèi)鏡黏膜下剝離術(shù)是一個在內(nèi)鏡下進(jìn)行胃腸道病變整塊切除的微創(chuàng)手術(shù)方式,然而,取得良好的ESD治療效果則需要一位具有豐富經(jīng)驗和嫻熟技能的醫(yī)師進(jìn)行操作。目的：本研究通過研究胃腸道不同大小、位置、病理類型的病變ESD術(shù)后并發(fā)癥發(fā)生率和復(fù)發(fā)率來評估ESD治療效果。并通過病理組織學(xué)檢查對切除病變的水平和垂直邊緣病變殘留率進(jìn)行評估。研究方法：回顧性研究,東南大學(xué)附屬中大醫(yī)院2010年5月至2015年3月179例患者ESD術(shù)病例資料,對上述患者ESD術(shù)后的并發(fā)癥、病變復(fù)發(fā)和通過病理組織學(xué)檢查對切除病變的水平和垂直邊緣病變殘留率進(jìn)行數(shù)據(jù)統(tǒng)計,并對統(tǒng)計資料通過SPSS軟件進(jìn)行t檢驗及卡方檢驗進(jìn)行分析。結(jié)果：收集的179例患者中,共有男性93例,女性86例。上述患者ESD術(shù)后并發(fā)癥發(fā)生率、復(fù)發(fā)率、以及病理組織學(xué)檢查標(biāo)本水平和垂直病變殘留率均較低(分別為8.9%、5%、11.2%)。 研究發(fā)現(xiàn)任何并發(fā)癥出現(xiàn)率、病變復(fù)發(fā)率和病理檢查發(fā)現(xiàn)切除標(biāo)本水平和垂直邊緣病變殘留率與性別和病變的大小無關(guān)(P0.05)。不同類型病變(息肉、早癌、癌、良性腫瘤和其他類型病變)的并發(fā)癥發(fā)生率無顯著統(tǒng)計學(xué)意義(P=0.103)。不同類型病變經(jīng)ESD切除后,手術(shù)標(biāo)本水平和垂直邊緣發(fā)現(xiàn)病變殘留率無明顯統(tǒng)計意義(P=0.223)。然而,不同類型病變的復(fù)發(fā)率差異具有顯著統(tǒng)計學(xué)意義(P=0.023)。病變復(fù)發(fā)多見于通過ESD切除的惡性腫瘤3/12；25%,而未見于ESD切除的息肉0/19；0%。結(jié)論：1.總的來說,ESD是一個安全、具有良好治療效果的手術(shù)方式,可以用于切除胃腸道不同部位的多種類型病變。2.患者的性別和年齡對ESD療效無任何影響。3.在切除的標(biāo)本邊緣能找到殘留組織,這可能是切除部位能見度有限以及操作困難的結(jié)果,但是殘留組織與病灶的類型、大小、部位的關(guān)系并不顯著。
[Abstract]:Background: endoscopic submucosal dissection is a minimally invasive surgery, gastrointestinal lesions in endoscopic resection achieved good therapeutic effect however, ESD is required to operate a highly experienced and skilled physicians. Objective: through the study on the gastrointestinal tract of different size, location, pathological types of lesions the ESD incidence rate of postoperative complications and recurrence rate to evaluate the therapeutic effect of ESD. And by histopathological examination of the residual lesion in the horizontal and vertical edge disease rate were evaluated. Methods: retrospective study in Zhongda Hospital Affiliated to Southeast University from May 2010 to March 2015, 179 cases of patients with ESD cases, the ESD of patients with postoperative complications, recurrence and the histopathologic examination of the lesions in the horizontal and vertical edges of residual lesion rate for statistical data, and the statistical data. T test SPSS software and chi square test were analyzed. Results: 179 patients were collected, there were 93 cases of male and female 86 cases. The patients with ESD postoperative complication rate, recurrence rate, and histopathological examination of the specimens of horizontal and vertical residual lesion rate was lower (respectively 8.9%, 5%, 11.2%). The study found that any complication rate, recurrence rate and pathological examination found specimens of horizontal and vertical edges of residual disease and gender and lesion size independent (P0.05). Different types of lesions (polyps, early cancer, cancer, benign tumor and other types of lesions) the incidence of complications was not statistically significant. (P=0.103). Different types of lesions after ESD resection, surgical specimens of horizontal and vertical edges found in residual lesion rate has no obvious statistical significance (P=0.223). However, different types of disease recurrence rate difference was statistically significant (P=0.0 23). Recurrence in malignant tumor resection by 3/12 ESD; 25%, but not in ESD 0/19 0%. resection of polyps; conclusion: 1. in general, ESD is a safe surgical method has good treatment effect, can be used for removal of gender and age in different parts of the various types of gastrointestinal lesions in patients with.2. the effect of ESD without any effect of.3. can find residual tissue in the specimen edge cutting, which may be excised and the operation of limited visibility difficult results, but the residue type, and the size of the lesion, parts of the relationship is not significant.

【學(xué)位授予單位】：東南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R57

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 Naomi Kakushima;Mitsuhiro Fujishiro;;Endoscopic submucosal dissection for gastrointestinal neoplasms[J];World Journal of Gastroenterology;2008年19期

2 Mitsuhiro Fujishiro;;Endoscopic submucosal dissection for stomach neoplasms[J];World Journal of Gastroenterology;2006年32期

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本文編號：1415196