我区内首例食管早期癌症ESD治疗在区人民医院成功开展

来源: 郫都区人民医院/pxrmyy120
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区人民医院成功开展

我区内首例食管早期癌症ESD治疗

新技术

       近日,成都市郫都区人民医院再次传来捷报,在医院消化内科主任吴攀率领下,该科室技术骨干及麻醉科相关医务人员的协助下,成功为一中老年男性食管早期癌症患者实施了我区首例内镜粘膜下剥离术(ESD),完整切除患者的食道肿瘤。此项新技术的成功开展,为我区早期消化道肿瘤患者的诊断和治疗提供了全新的治疗方式。

没想到得了癌症,现在不用开刀,这么快就可以治疗出院,真是太谢谢你们啦!

61岁的

杨大爷


  拉着消化科吴攀主任的手,再次表达了感激之情。

临床症状

        原来,杨大爷近一个月来感觉吞咽困难逐渐加重,遂来到区人民医院内镜室行内镜检查,在检查过程中发现他的食道粘膜粗糙,怀疑食道早癌病变,主治医师黄长玉立即为患者进行活检检查,经病理科专家仔细分析,结果显示鳞状上皮高级别上皮内瘤变,提示早癌。

听癌色变

        患者一家听说癌症,一下慌了神,杨大爷可是家里的顶梁柱啊!这种情况以前都是外科手术。但外科手术需开胸、创伤大、恢复慢、花费多。考虑到患者的实际情况,吴主任同主治医生黄长玉充分讨论后,决定为该患者实施消化内科领域较前沿且技术较成熟的内镜粘膜下剥离术(ESD)。

手 术 顺 利 进 行

       在完善相关检查后,吴主任和黄医生成功将患者约7cm病变整块切除。术后患者恢复良好,无感染、出血等并发症,手术后一天即可以恢复饮食,手术后一周就可以出院。

吴 攀

    内镜粘膜下剥离术(Endoscopic submucosal dissection,ESD),是目前最高技术难度的内镜微创手术技术,是一种治疗癌前病变及消化道早期癌症的新技术,与外科剖腹手术及内镜粘膜切除术等内镜治疗方法相比,具有明显优势。能够一次性完全切除直径大于2cm,甚至达到近10cm的病变,具有疗效好、创伤小、恢复快等优点,同时患者可接受多个部位多次治疗,使医生能获得完整的组织病理标本以供分析。

知识链接

食管癌

 

         中国是食管癌高发地区,食管黏膜病变尤其是高级别上皮内瘤变和早期食管鳞癌的诊治是食管癌防治的重点内容。消化道癌症的预后与诊治时机密切相关,进展期癌症即使接受了以外科手术为主的综合治疗,5年生存率仍低于30%,且生活质量低,给家庭及国家带来沉重的负担;而大部分消化道早癌在内镜下即可获得及时性治疗,5年生存率超过90%,大大节约了医疗资源。

ESD诊疗范围

1

早期癌:根据医生经验,结合染色、放大和超声等其它内镜检查方法,确定肿瘤局限在黏膜层和没有淋巴转移的黏膜下层,ESD切除肿瘤可以达到外科手术同样的治疗效果。

2

巨大平坦息肉:超过2厘米的息肉尤其是平坦息肉,推荐ESD治疗,一次、完整的切除病变。

3

黏膜下肿瘤:超声内镜诊断的脂肪瘤、间质瘤和类癌等,如位置较浅(来源于黏膜肌层和黏膜下层),通过ESD可以完整剥离病变。


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