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首页> 外文期刊>Surgical Endoscopy >Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife for superficial esophageal neoplasia. Is it safe for elderly patients?
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Endoscopic submucosal dissection with a combination of small-caliber-tip transparent hood and flex knife for superficial esophageal neoplasia. Is it safe for elderly patients?

机译：内窥镜下黏膜下剥离术结合小口径透明罩和弯刀，用于食管浅表瘤形成。对老年患者安全吗？

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BACKGROUND: Safety and efficacy of endoscopic submucosal dissection (ESD) for esophageal neoplasias have not been adequately investigated in elderly patients. This study was designed to evaluate the safety and efficacy of ESD for esophageal neoplasias in elderly patients. METHODS: Fifty-three superficial esophageal neoplasias treated with ESD using a combination of small-caliber-tip transparent hood and flex knife from May 2006 to June 2009 were divided into elderly group (aged 70 years or older: 25 lesions in 23 patients) and nonelderly group (younger than aged 70 years: 28 lesions in 25 patients). Therapeutic efficacy, complications, and follow-up results were evaluated retrospectively. RESULTS: The history of cerebral infarction or cardiopulmonary disease and the usage of antiplatelet agents or anticoagulants were significantly higher in elderly group (p 0.0050 and p 0.0013, respectively). Median procedural times in the elderly group and the nonelderly group were 93 +/- 53 (range, 42-235) min and 95 +/- 55 (range, 40-230) min (p 0.73), respectively. Median sizes of the neoplasias and the resected specimens were 14 +/- 11 (range, 5-45) mm and 15 +/- 17 (range, 5-83) mm (p 0.56), and 35 +/- 12 (range, 18-60) mm and 38 +/- 17 (range, 18-90) mm (p 0.38), respectively. En bloc resection rate was 100% in each group. Body temperature and white blood cell counts of the next day after ESD were significantly higher in the nonelderly group than in the elderly group (p 0.0087 and p 0.0043, respectively). There were no complications, such as postoperative bleeding or perforation, in each group. The median follow-up period of 23 +/- 10 (range, 4-35) months in the elderly group revealed no local or distant metastasis. CONCLUSIONS: ESD with a combination of small-caliber-tip transparent hood and flex knife is a safe and effective treatment for superficial esophageal neoplasia in elderly and nonelderly patients.
机译：背景：对于老年患者，内镜下粘膜下剥离术（ESD）治疗食管肿瘤的安全性和有效性尚未得到充分研究。本研究旨在评估ESD对老年患者食管瘤形成的安全性和有效性。方法：2006年5月至2009年6月，采用小口径透明罩和弯曲刀联合ESD治疗的食管浅表瘤病53例，分为老年组（年龄70岁或以上：23例患者中有25个病灶）和非老年组（年龄小于70岁：25例患者有28个病变）。回顾性评价治疗效果，并发症和随访结果。结果：老年组脑梗死或心肺疾病的病史以及抗血小板药或抗凝剂的使用率显着更高（分别为P 0.0050和P 0.0013）。老年人组和非老年人组的中位手术时间分别为93 +/- 53分钟（42-235）分钟和95 +/- 55（40-230）分钟（p 0.73）。赘生瘤和切除标本的中位大小为14 +/- 11（范围，5-45）mm和15 +/- 17（范围，5-83）mm（p 0.56）和35 +/- 12（范围，18-60）毫米和38 +/- 17（18-90）毫米（p 0.38）。每组的整体切除率为100％。非老年人组ESD后第二天的体温和白细胞计数显着高于老年人组（分别为p 0.0087和p 0.0043）。每组均无并发症，如术后出血或穿孔。老年组的中位随访期为23 +/- 10（范围：4-35）个月，未发现局部或远处转移。结论：ESD结合小口径透明罩和弯刀是治疗老年和非老年患者浅表食管肿瘤的安全有效方法。

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