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| 1 | Comparing outcomes for endoscopic submucosal dissection between Eastern and Western countries:A systematic review and meta-analysis显示文摘AIM To compare endoscopic submucosal dissection(ESD) outcomes between Eastern and Western countries.METHODS A systematic review and meta-analysis was performed using Pub Med,MEDLINE,Web of Science,CINAHL and EBM reviews to identify studies published between 1990 and February 2016. The primary outcome was the efficacy of ESD based on information about either curative resection,en bloc or R0 resection rates. Secondary outcomes were complication rates,local recurrence rates and procedure times. RESULTS Overall,238 publications including 84318 patients and 89512 gastrointestinal lesions resected using ESD were identified. 90% of the identified studies reporting ESDon 87296 lesions were conducted in Eastern countries and 10% of the identified studies reporting ESD outcomes in 2216 lesions were from Western countries. Meta-analyses showed higher pooled percentage of curative,en bloc,and R0 resection in the Eastern studies; 82%(CI: 81%-84%),95%(CI: 94%-96%) and 89%(CI: 88%-91%) compared to Western studies; 71%(CI: 61%-81%),85%(CI: 81%-89%) and 74%(CI: 67%-81%) respectively. The percentage of perforation requiring surgery was significantly greater in the Western countries(0.53%; CI: 0.10-1.16) compared to Eastern countries(0.01%; CI: 0%-0.05%). ESD procedure times were longer in Western countries(110 min vs 77 min).CONCLUSION Eastern countries show better ESD outcomes compared to Western countries. Availability of local ESD expertise and regional outcomes should be considered for decision making to treat gastrointestinal lesions with ESD. | Dane Christina Daoud Nicolas Suter Madeleine Durand Mickael Bouin Bernard Faulques Daniel von Renteln | 2018 | World Journal of Gastroenterology2018，24，23： | 8 |
| 2 | 内镜黏膜下剥离术治疗贲门部早癌及癌前病变的疗效分析显示文摘目的探讨内镜黏膜下剥离术(ESD)治疗贲门部早癌及癌前病变的疗效性及安全性。
方法回顾性分析2009年2月至2015年2月间在武汉大学人民医院行ESD治疗的51例贲门部早癌及癌前病变的患者的临床资料,分析患者术中、术后及随访情况。
结果全组51例患者均顺利完成手术,手术时间20~180(平均数52 min)。发生术中出血者21例(41.2%)、术中穿孔3例(5.9%);所有病变均完整切除,切除病变直径2.0~3.5(平均数2.7)cm。术后发生迟发性出血者4例(7.8%),均再次行内镜下止血手术成功止血;全组患者术后无进食梗阻、食管反流及其他严重并发症发生。术后病理提示:早癌10例,高级别上皮内瘤变35例,低级别上皮内瘤变6例;病灶切缘无癌细胞残留。术后随访至第6个月创面均愈合,无复发病例。
结论ESD是治疗贲门部早癌及癌前病变的一种安全及有效的方法。 | 王珊珊 沈磊 | 2016 | 中华胃肠外科杂志2016，19，2： | 7 |
| 3 | 内镜黏膜下剥离术治疗贲门部病变的进展显示文摘20世纪80年代日本学者开始采用EMR治疗消化道局部黏膜病变,明显提高了患者术后生活质量,但对于较大病变(直径〉20mm),需要采取分次切除,会对病变本身范围的评估产生影响。1996年日本学者首次使用顶端带有绝缘陶瓷圆球的电刀(即IT刀)对直肠的平坦病变成功进行一次性的切除,之后在此基础上最终形成了成熟的。 | 王珊珊 沈磊 | 2016 | 中华消化内镜杂志2016，33，1： | 5 |
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