Objective To investigate the efficacy and safety of endoscopic submucosal dissection (ESD) for gastrointestinal elevated lesions including early cancer. Methods Between August 2008 to October 2011,18 cases of gastrointestinal elevated lesions were managed by ESD after endoscopic ultrasonography examination. Results All lesions were removed completely for only once. The lesions ranged from 0.8 cm to 5 cm with a mean size of 1.6 cm. The mean ESD procedure time was 75 min ( ranged from 40 min to 120 min ). One case of delayed bleeding and two cases of perforation occurred and had been cured after conservative treatment Pathological examination showed 2 cases of stromal tumors, 2 cases of polyps, one case of ectopic pancreas, seven cases of intraepithelial neoplasia, six cases of early carcinoma. Histological evaluation showed that the tunica of the tumors was intact, and both the lateral and basal margins of the specimens were free of tumor cells. Followed up for 2 and 6 months after operation, all the cases were confirmed healing of the artificial ulcer with no residue or recurrence. Conclusion ESD is efficacious and safe to treat gastrointestinal elevated lesions. It is possible to completely remove submucosal lesions and provide sufficient pathological information, which can be used to treat early cancer.%目的 探讨内镜黏膜下剥离术(ESD)治疗消化道隆起性病变(含早癌)的疗效和安全性.方法 对2008年8月至2012年6月南京明基医院消化科内镜中心发现的18例消化道隆起性病变行ESD治疗.术前行超声内镜确认病灶的深度.结果 手术全部一次性切除成功.病变长径0.8～5 cm(平均1.63 cm),ESD手术时间40～120 mm(平均75 min),术后1例出血,2例穿孔,皆保守治疗后治愈.术后病理提示间质瘤2例,息肉2例,1例异位胰腺,7例上皮内瘤变,6例早癌.所有ESD切除病变全部送检病理确诊,基底和切缘未见病变累及.术后随访,创面愈合,无病变残留和复发.结论 ESD治疗消化道隆起性病变安全有效,可以提供完整的病理诊断学资料.ESD可用于治疗消化道早癌.
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