Endoscopic submucosal dissection - a minimally invasive approach to the treatment of early gastrointestinal cancer and precancerous lesions,
Endoscopic submucosal dissection - a minimally invasive approach to the treatment of early gastrointestinal cancer and precancerous lesions, as well as surgical procedures, is a endoscopic submucosal dissection Endoscopic submucosal dissection (ESD) refers to the use of endoscopic high-frequency electric knife, and special equipment, the gastrointestinal lesions (including early gastrointestinal tumors) and below normal mucosa gradually stripped, in order to achieve the purpose of the resection. ESD is a new technique developed by endoscopic mucosal resection. It has become an effective method for the treatment of early gastrointestinal cancer and precancerous lesions. Endoscopic submucosal dissection is mainly suitable for the treatment of lesions The utility model is mainly suitable for early gastrointestinal cancer or precancerous lesions, which is confined to the mucosal layer or only the superficial submucosal invasion. Clinically, ESD is often used in the treatment of gastrointestinal diseases: 1, gastrointestinal polyps and a variety of precancerous lesions, especially the diameter of more than 2cm lesions, recommended ESD treatment, can be a complete resection of lesions. 2, early gastrointestinal cancer, combined with pigment magnifying endoscopy, endoscopic ultrasonography, identify early tumor invasion scope and depth of confined to the mucosa and submucosa of early cancer without lymph node metastasis, ESD surgical treatment can achieve the same radical effect. 3, submucosal tumors, such as leiomyoma, stromal tumor, lipoma, endoscopic ultrasonography to determine the origin of the muscularis mucosae and submucosal tumors, ESD treatment can be completely removed lesions. In Japan, more than half of early gastric cancer and colorectal cancer are treated with ESD. What are the advantages of endoscopic submucosal dissection? ESD and mucosal resection have the same purpose and similar approach, but the advantage is: can be removed more than 2cm of the larger lesions, and has a low recurrence rate. In the early stage of digestive tract cancer, surgical treatment is the main method in the early stage, but the trauma is large, the patient is slow to recover, and the removal of diseased organs often leads to different degrees of dysfunction. ESD can be used to remove a large lesion at once, to avoid residual tumor and recurrence, compared with the traditional subtotal gastrectomy or early gastrointestinal cancer radical operation, ESD damage is small, low cost, fast recovery. The safety of endoscopic submucosal dissection is the same as that of other endoscopic treatments, and ESD has some risks. The main complications were hemorrhage, perforation, the incidence rate is about 5% - 8%. For bleeding in electrocoagulation or using titanium clips and other methods to control bleeding under endoscope, can effectively prevent intraoperative and postoperative application of hemostatic drugs before and after surgery; perforation complicated with ESD is usually very small, generally can be found in the operation, to titanium clip suture, gastrointestinal decompression, fast cure prevention and treatment of infection after operation method. Only a small number of patients require surgical treatment. Even so, ESD is a simple, effective, minimally invasive, and curative effect of surgical treatment of gastrointestinal tract is equivalent to the method. Patients with dissection in matters of endoscopic mucosal endoscopic submucosal dissection should be paid attention to, after surgery should be fasting for 1-2 days, 1 weeks to liquid digestible diet, the use of acid suppressive drugs, mucosal protective agents, and prevention of infection. After 2 days should be noted that there is no abdominal distension, abdominal pain, hematemesis, melena, note the occurrence of complications such as bleeding and perforation. After February, the patients should be examined for gastrointestinal endoscopy in order to understand the wound healing and the residual of the lesion.