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首页> 美国卫生研究院文献>Gastroenterology Research and Practice >Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location considering Both Mucosal Circumferential Incision and Submucosal Dissection
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Procedure Time for Gastric Endoscopic Submucosal Dissection according to Location considering Both Mucosal Circumferential Incision and Submucosal Dissection

机译：同时考虑粘膜周切口和粘膜下剥离的胃内镜下粘膜下剥离的手术时间

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摘要

Background. Previous assessments of technical difficulty and procedure time for endoscopic submucosal dissection (ESD) of gastric neoplasms did not take into account several critical determinants of these parameters. However, two key phases of ESD determine the total procedure time: the mucosal circumference incision speed (CIS) and submucosal dissection speed (SDS). Methods. We included 302 cases of en bloc and R0 resection of gastric neoplasms performed by 10 operators who had completed the training program at our hospital. Twelve locations were classified based on multiple criteria, such as condition of surrounding mucosa, lesion vascularity, presence of submucosal fat, ulcers, scars, fibrosis, and scope and device maneuverability. Lesions in different locations were classified into three groups based on the length of the procedure: fast, moderate, or late. Results. A significant difference was found in CIS and SDS for each location (p < 0.01), which demonstrates the validity of this classification system. In several locations, CIS and SDS were not consistent with each other. Conclusion. CIS and SDS did not correspond to each other even for lesions in the same location. Consideration of ESD procedure time for gastric neoplasms requires a more elaborate classification system than that previously reported.
机译：背景。先前对胃肿瘤的内镜下黏膜下剥离术（ESD）的技术难度和手术时间的评估并未考虑这些参数的几个关键决定因素。但是，ESD的两个关键阶段决定了整个手术时间：粘膜周围切口速度（CIS）和粘膜下剥离速度（SDS）。方法。我们纳入了302例由10名在我们医院完成培训计划的操作员进行的胃肿瘤整块和R0切除术。根据多个标准对十二个位置进行了分类，例如周围粘膜的状况，病变血管，粘膜下脂肪的存在，溃疡，疤痕，纤维化以及范围和器械可操作性。根据手术时间的长短，将不同位置的病变分为三组：快，中或晚期。结果。在每个位置的CIS和SDS中发现了显着差异（p <0.01），这证明了此分类系统的有效性。在几个地方，CIS和SDS彼此不一致。结论。 CIS和SDS甚至在同一位置的病变之间也不对应。考虑到胃肿瘤的ESD手术时间，需要比以前报道的系统更加精细的分类系统。

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