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| 1 | 内镜黏膜下剥离术治疗早期胃癌可行性及手术指征分析显示文摘目的回顾分析手术治疗的早期胃癌病理资料,探讨早期胃癌行内镜黏膜下剥离术(ESD)的可行性和手术指征。方法收集上海华山医院2007至2011年间经手术治疗的胃癌病理资料,分析符合日本胃癌协会ESD治疗标准的早期胃癌的情况。比较不同浸润深度、分化类型的早期胃癌局部转移的情况。结果2007至2011年间共手术治疗胃癌1159例,其中早期胃癌210例(18.1%),有151例符合ESD扩大指征,126例符合ESD标准适应证,分别占胃癌手术量的13.0%、10.9%,占早期胃癌的71.9%、60.0%。在210例早期胃癌中,黏膜内癌(m癌)、黏膜肌层癌(mm癌)、黏膜下层第1层癌(sm1癌)、黏膜下层第2层癌(sm2癌)的局部转移率分别为6.8%(5/74)、15.0%(6/40)、23.3%(10/43)、39.6%(21/53),组间比较差异有统计学意义(P〈0.01)。分化型早癌与非分化型早癌的局部转移率分别为14.0%(24/172)、47.4%(18/38)(P〈0.01)。结论行胃癌根治术的早期胃癌患者较大部分可以选择ESD治疗。早期胃癌的区域转移与浸润深度和分化程度明显相关,故有必要严格掌握ESD的适用指征。 | 陈坚 周仲文 邱志兵 黄剑平 钟良 | 2013 | 中华消化内镜杂志2013，30，1： | 14 |
| 2 | Impact of tumor location on clinical outcomes of gastric endoscopic submucosal dissection显示文摘AIM:To determine whether there is a correlation between the location of the lesion and endoscopic submucosal dissection(ESD)outcome.METHODS:From January 2008 to December 2010,ESD of 1443 gastric tumors was performed.En bloc resection rate,complete resection rate,procedure time and complication rate were analyzed according to the tumor location.RESULTS:The rates of en bloc resection and complete resection were 91%(1318/1443)and 89%(1287/1443),respectively.The post-ESD bleeding rate was 4.3%,and perforation rate was 2.7%.Tumors located in the upper third of the stomach were associated with a longer procedure time and significantly higher rates of incomplete resection,piecemeal resection,and perforation than tumors below the upper third of the stomach.Posterior wall lesions had significantly longer procedure times and higher rates of incomplete resection and piecemeal resection than lesions in other locations.In multivariate analysis,posterior wall lesions and upper third lesions were significantly associated with incomplete resection and perforation,respectively.In post-ESD bleeding analysis,location was not a significant related factor.CONCLUSION:More advanced endoscopic techniques are required during ESD for lesions located in the upper third or posterior wall of the stomach to decrease complications and improve therapeutic outcomes. | Ji Young Yoon Choong Nam Shim Sook Hee Chung Wan Park Hyunsoo Chung Hyuk Lee Sung Kwan Shin Sang Kil Lee Yong Chan Lee Jun Chul Park | 2014 | World Journal of Gastroenterology2014，20，26： | 10 |
| 3 | 消化内镜新技术及在早期胃癌诊治中的应用显示文摘胃癌的早期诊断、早期治疗对提高胃癌治疗的疗效、改善患者预后具有十分重要的意义。近年来,各类新型消化内镜不断出现,对早期胃癌的诊断和治疗起到了很大的推动作用。本文就这些消化内镜新技术以及内镜下黏膜切除术、内镜下黏膜下剥离术等早期胃癌的内镜下微创治疗方法作一介绍。 | 陈坚 | 2014 | 上海医药2014，35，1： | 7 |
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