Early Diagnosis And Endoscopic Minimally Invasive Treatment of Gastrointestinal Tumor

Objective To study the efficiency and complications of endoscopic submucosal dissection (ESD) and endoscopic submucosal tunnel dissection (ESTD) in the treatment of large esophageal mucosal lesions. Methods The clinical data were collected from the patients who received ESD or ESTD for the treatment of early esophageal lesions in our hospital during January 1, 2014 to July 15, 2015, including the en bloc resection rate, curative resection rate, postoperative complication rate, the risk factors of complications were explored by univariate and multivariate analysis. Results A total of 50 patients were involved in the study, ESD or ESTD were performed successfully in 53 times, including 6 cases of ESD,47 cases of ESTD, The average age was (61.9±6.8) yr., the average operating time was (83.57±32.33) min, the average dissected lesion was (14.82±3.18) cm², En bloc resection rate was 94.34%, the curative rate was 84.90%. There were 1 case of bleeding, 1 case of perforation, 45 (84.90%) cases of fever, 13 cases (24.53%) of esophageal stricture. The severity of stricture was associated with the operation time 〔odds ratio (OR=1.040, 95%confidence interal (CI: 1.007-1.075〕 and esophageal circumference (OR=9.972,95%CI: 1.221-81.416).The residual resection margin appeared in 8 patients, and the lesion area (OR=1.145,95%CI: 1.013-1.294) was the only risk factor. Conclusion ESD and ESTD are safe and effective in the treatment of early esophageal lesions, but seems have relatively high incidence of esopgageal stricture and residual resection margin in the treatment of large esophageal lesions.