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Endoscopic Submucosal Dissection: Indications and Application in Western Endoscopy Practice.
内镜黏膜下剥离术: 西方内镜实践中的适应症和应用。
Endoscopic Mucosal Resection Endoscopic Submucosal Dissection Gastric Cancer Polypectomy
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摘要

Endoscopic submucosal dissection was developed in Japan, early in this century, to provide a minimally invasive yet curative treatment for the large numbers of patients with early gastric cancer identified by the national screening program. Previously, the majority of these patients were treated surgically at substantial cost and with significant risk of short- and long-term morbidity. En-bloc excision of these early cancers, most with a limited risk of nodal metastasis, allowed complete staging of the tumor, stratification of the subsequent therapeutic approach, and potential cure. This transformative innovation changed the nature of endoscopic treatment for superficial mucosal neoplasia and, ultimately, for the first time allowed endoscopists to assert that the early cancer had been definitively cured. Subsequently, Western endoscopists have increasingly embraced the therapeutic possibilities offered by endoscopic submucosal dissection, but with some justifiable scientific caution. Here we provide an evidence-based critical appraisal of the role of endoscopic submucosal dissection in advanced endoscopic tissue resection.

译文

内镜黏膜下剥离术于本世纪初在日本发展起来,为国家筛查项目确定的大量早期胃癌患者提供微创而有疗效的治疗。以前,这些病人中的大多数都是以巨大的成本接受手术治疗,并且有很大的短期和长期发病率的风险。这些早期癌症的整块切除,大多数淋巴结转移的风险有限,允许肿瘤的完全分期、后续治疗方法的分层和潜在的治愈。这一变革性的创新改变了表面黏膜瘤变内窥镜治疗的本质,并最终首次允许内镜医师断言早期癌症已经完全治愈。随后,西方内镜医师越来越多地接受内镜黏膜下剥离术提供的治疗可能性,但也有一些合理的科学谨慎。在这里,我们提供了一个基于证据的对内镜黏膜下剥离术在晚期内镜组织切除中的作用的关键评价。

Endoscopic Submucosal Dissection

消化 癌前病变治疗 手术
概述  :  

内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)是指利用各种电刀对大于2 cm的病变进行黏膜下剥离的内镜微创技术。这一技术可以实现较大病变的整块切除。并提供准确的病理诊断分期。随着内镜器械的不断发展,ESD已成为消化道早癌及癌前病变的首选治疗方法。 适应症(1)早期食管癌及痛前病变  ①大于15 mm的食管高级别上皮内瘤变;②早期食管癌;③伴有不典型增生和癌变的Barrett食管;④姑息性治疗;(2)早期胃癌及癌前病变

endoscopic  [ˌendəs'kɒpɪk] [ˌendəs'kɒpɪk]

释义   adj. 内窥镜的;用内窥镜检查的

例句   Objective: To discuss gastrointestinal polyp typing and endoscopic therapy for " small polyp" .目的:讨论消化道息肉的分型与小型息肉内镜治疗。

 

submucosal  [ˌsʌbmjʊˈkəʊsəl]

释义   adj. 粘膜下层的

例句   Arterial bleeding is seen in the submucosal layer. 动脉血在粘膜下层可看到。

 

dissection [daɪ'sekʃn] [dɪˈsɛkʃən, daɪ-]

释义   n. 解剖,切开;解剖体;详细查究

例句   However, as has been the case previously, the headline numbers, upon further review and dissection, may not be as positive as initially reported and received. 然而,正如之前的情况一样,经过进一步审查和剖析后,标题数字可能不如最初报告和收到的那样积极。


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