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内镜黏膜下剥离术(ESD)是一种内镜下整块切除病变黏膜的治疗方法,已经成为早期胃癌的治疗选择之一。目前ESD治疗早期胃癌较为积极的指征为:(1)分化型黏膜内癌如果表面未形成溃疡,则病变大小不受限制;(2)分化型黏膜内癌如果表面已经形成溃疡,则病变直径≤30mm;(3)分化型sm1癌,病变直径≤30mm;(4)未分化型黏膜内癌,表面未形成溃疡,且病变直径≤20mm。尽管长期随访的资料较少,但目前看来,如果合理地把握ESD治疗指征,早期胃癌的治愈率与手术相当,但可减少并发症,提高病人生活质量,具有安全、可行、有效的特点。
Endoscopic submucosal dissection (ESD) is a method of endoscopic resection of the lesion mucosa, which has become one of the treatment options for early gastric cancer. The current treatment of early gastric cancer with ESD is more active indications: (1) differentiated intramucosal carcinoma if the surface does not form an ulcer, the lesion size is not limited; (2) differentiated intramucosal carcinoma if the surface has formed an ulcer, the lesion diameter ≤ 30mm; (3) differentiated sm1 cancer, pathological diameter ≤ 30mm; (4) undifferentiated intramucosal cancer, the surface does not form an ulcer, and lesion diameter ≤ 20mm. Although data on long-term follow-up are few, it seems that if the indication of ESD treatment is reasonable, the cure rate of early gastric cancer is similar to that of surgery, but it can reduce the complications and improve the quality of life of the patients, which is safe, feasible and effective .