摘要目的 探讨早期食管病变内镜黏膜下剥离术(ESD)后黏膜缺损范围在1/2~<3/4环周患者术后食管狭窄发生情况,以及狭窄相关危险因素分析.方法 回顾性分析2013年1月至2015年8月因早期食管病变行ESD治疗的301例患者资料,统计分析不同剥离范围患者术后食管狭窄发生率,分析狭窄的危险因素.结果 食管1/2~<3/4环周剥离的113例患者中术后发生食管狭窄13例,狭窄发生率为11.5%,未出现严重狭窄;狭窄组与未狭窄组在性别构成、年龄、家族史、伴发疾病、病变形态、操作时间、病变纵向长度、浸润深度、病理类型及术后并发症方面差异无统计学意义(P>0.05),在病变位置方面差异有统计学意义(P<0.05).结论 食管1/2~<3/4环周ESD术后狭窄发生率相对较低,其狭窄的发生与病变位置有关,食管上段病变ESD术后更容易发生狭窄.

abstractsObjective To analyze the incidence and risk factors of postoperative esophageal stenosis after endoscopic submucosal dissection(ESD)with mucosal defect of 1/2?<3/4 circumference. Methods A retrospective analysis was performed on the data of 301 patients with early esophageal cancer or precancerous lesions undergoing ESD at Drum Tower Hospital between January 2013 and August 2015. The incidence and risk factors for postoperative stenosis were analyzed. Results Esophageal stenosis was observed in 13 cases among the 113 cases of 1/2?<3/4 circumference mucosal defect. The rate of stenosis was 11.5%. There was no significant difference between stenosis group and non?stenosis group in regard of gender, age, family history, concomitant diseases, lesion type, operation time, invasion depth, lesion longitudinal length,pathological diagnosis or complications after ESD(P>0.05),while the rate of lesions in the upper esophagus in stenosis group was higher than that in the control group(P<0.05). Conclusion Mucosal defect of 1/2?<3/4 circumference has a lower esophageal stenosis rate after ESD,which is related to the location of lesion. The ratio of upper esophagus lesion in the stenosis group is significantly higher than that in the non?stenosis group.