经内镜隧道式黏膜下剥离术（ESTD）已用于大型食管肿瘤性病变的切除，但是在治疗圆周浅表性食管肿瘤病变中还存在一些技术问题。本研究的目的是，在所选定的随访1-12个月的患者中，评估经内镜多隧道式黏膜下剥离术（ESMTD）对食管肿瘤圆周浅表性食管肿瘤病变的有效性和安全性。

从年7月至年2月，连续7例圆周浅表性食管肿瘤病变的患者在内镜中心接受了ESMTD。根据浅表性肿瘤病变的巴黎内镜分类法对肉眼可见类型进行分类。

所选7例患者的病变长度平均为6.1厘米。手术时间介于69分钟到分钟（平均分钟）。实现了所有病变中阴性基底边缘的整块切除，并且没有出现严重手术不良事件。所有患者在术后1-3个月均出现了食管狭窄，安放可回收金属支架或者进行食管球囊扩张术均可缓解食管狭窄。然而，1例病人在接受ESMTD后2个月死于脑梗塞。

结论：ESMTD对所选患者圆周浅表性食管肿瘤病变的治疗是可行的，安全的，有效的。

Endoscopicsubmucosalmulti-tunneldissectionforcircumferentialsuperficialesophagealneoplasticlesions

GanT1,YangJL1,ZhuLL1,WangYP1atal.

1DepartmentofGastroenterologyandHepatology,WestChinaHospital,SichuanUniversity,China.

Abstract

BACKGROUNDANDAIMS:

Endoscopicsubmucosaltunneldissection(ESTD)hasbeenusedfordissectionoflargeesophagealneoplasticlesions,buttherearestillsometechnicalproblemsintreatingcircumferentialsuperficialesophagealneoplasticlesions.Thisstudyaimedtoassesstheefficacyandsafetyofendoscopicsubmucosalmulti-tunneldissection(ESMTD)forcircumferentialsuperficialesophagealneoplasticlesionsinselectedpatientsfollowedupfor1to12months.

METHODS:

FromJulytoFebruary,thefirstseriesof7consecutivepatientswithcircumferentialsuperficialesophagealneoplasticlesionsunderwentESMTDatourendoscopiccenter.ThemacroscopictypeswereclassifiedaccordingtotheParisendoscopicclassificationofsuperficialneoplasticlesions.

RESULTS:

Theaveragelengthoflesionswas6.1cmin7selectedpatients.Theoperativetimerangedfrom69tominutes(meanminutes).Enblocdissectionwithnegativebasalmarginswasachievedinalllesionswithoutseriousintraoperativeadverseevents.Esophagealstricturewasobservedinallpatients1to3monthsaftertheoperationandwasrelievedafteraretrievablemetalstentwasplacedoresophagealwaterballoondilatationwasperformed;however,onepatientdiedofcerebralinfarction2monthsafterESMTD.

CONCLUSIONS:

ESMTDisfeasible,safe,andeffectiveforthetreatmentofcircumferentialsuperficialesophagealneoplasticlesionsinselectpatients.

原文来源：GastrointestEndosc.Jan29.pii:S-(16)-7.doi:10.

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