中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (06): 491-493.

• 专题笔谈 • 上一篇    下一篇

内镜下黏膜剥离术在早期大肠癌及癌前疾病的应用

姚礼庆,张轶群,周平红   

  1. 复旦大学附属中山医院内镜中心,上海200032
  • 出版日期:2011-06-01 发布日期:2011-05-24

  • Online:2011-06-01 Published:2011-05-24

摘要:

大肠癌的癌前疾病是指业已证实与大肠癌发生密切相关的病理变化,包括腺瘤、腺瘤病及炎性肠病相关的异型增生。早期大肠癌是指病变局限于黏膜及黏膜下层的结直肠癌,而不论其大小及是否有淋巴结转移。内镜下黏膜剥离术(ESD)是近年来发展起来的新技术,在日本,ESD已经被确认为内镜治疗上消化道恶性肿瘤的标准方法,但尚未被确定为大肠早期癌和癌前疾病的内镜标准治疗方法,除了大肠ESD操作难度较高外,主要原因是大肠癌的病理学特点与食管癌、胃癌有很大区别。需要更多的临床资料来制定ESD治疗大肠病变的指南。

关键词: 内镜下黏膜剥离术, 早期大肠癌

Abstract:

Endoscopic submucosal dissection of early colorectal cancer and precancerous lesions        YAO Li-qing,ZHANG Yi-qun,ZHOU Ping-hong. Endoscopic Institute of Zhongshan Hospital of Fudan University, Shanghai 200032, China
Corresponding author: ZHANG Yi-qun,E-mail:zhang.yiqun@zs-hospital.sh.cn
Abstract    Precancerous lesions of colorectum include adenoma, familialadenomatouspolyposis and inflammatory bowel disease. Early colorectal carcinoma is defined as the lesion limited to the submucosal layer histologically regardless of size and nodal status. Endoscopic submucosal dissection (ESD) has been established as a standard method for the endoscopic ablation of malignant tumors in the upper gastrointestinal (GI) tract in Japan. But ESD has not yet been established as a standard therapeutic method for precancerous lesions and early carcinoma of colorectum because colorectal carcinoma has unique pathological characteristics that differ dramatically from the lesion of esophagus and stomach, and scope handling and control is more difficult in the colorectum than in the upper GI tract. More data is need to establish the standard ESD guideline in the colorectal cancer.

Key words: endoscopic submucosal dissection, early colorectal cancer