内镜黏膜下剥离术后食管狭窄预防新进展

New advances in the prevention of esophageal strictures after endoscopic submucosal dissection

摘要:

内镜黏膜下剥离术（ESD）是在内镜辅助下使用特殊电刀将病变完整剥离的微创技术，已成为治疗早期食管癌及癌前病变的主要手段，然而术后大面积黏膜缺损引发的食管狭窄会严重影响患者生活质量。目前虽已有多种手段预防食管ESD后狭窄，如物理扩张、药物预防、生物材料修复和组织工程学与再生医学的黏膜移植等，但对于狭窄的最佳预防策略尚未达成共识。该文就预防ESD后食管狭窄的研究进展进行综述。

Abstract:

Endoscopic submucosal dissection (ESD) is a minimally invasive technique that utilizes special electrosurgical knives under endoscopic guidance to completely remove lesions, and has become a primary treatment for early esophageal cancer and precancerous lesions. However, esophageal stenosis caused by large postoperative mucosal defects seriously affects patients' quality of life. Although various strategies exist to prevent post-ESD esophageal stenosis, including physical dilation, pharmacoprevention, biomaterial repair, and tissue engineering/regenerative medicine approaches (e.g., mucosal transplantation), no consensus exists on the optimal prevention strategy. This review discusses advances in the prevention of esophageal stenosis after ESD.