Kết quả điều trị tiền ung thư và ung thư sớm đường tiêu hoá bằng kỹ thuật nội soi cắt tách dưới niêm mạc (endoscopic submucosal dissection) tại Bệnh viện Đa khoa Tâm Anh Hà Nội=Result of endoscopic submucosal dissection for treatment of early stage cancer and precancerous lesion in the gastrointestinal tract in Tam Anh Ha Noi Hospital

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Trần Tiến Đào, Trường Khanh Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.201-208

Bộ sưu tập: Metadata

ID: 243883

Thêm vào giỏ

Đánh giá hiệu quả, độ an toàn của phương pháp cắt tách dưới niêm mạc (Endoscopic Submucosal Dissection) trong điều trị các tổn thương tiền ung thư và ung thư sớm đường tiêu hoá tại bệnh viện Đa khoa Tâm Anh Hà Nội. Đối tượng và phương pháp: nghiên cứu mô tả, cắt ngang có theo dõi. Tiêu chuẩn chọn: Bệnh nhân được chẩn đoán ung thư giai đoạn đầu hoặc tổn thương tiền ung thư ở đường tiêu hóa được điều trị bằng cắt tách dưới niêm mạc qua nội soi (ESD). Kết quả: 51 bệnh nhân được nhập viện cắt tách dưới niêm mạc qua nội soi từ ngày 12/2021 đến tháng 5/2024. Tỷ lệ nam/nữ: 1,6/1, tuổi trung bình 65,06 ± 9,90 gồm u thực quản (4 bệnh nhân), u dạ dày (15 bệnh nhân) và đại tràng (32 bệnh nhân). Kích thước khối u trung bình là 42,1 ± 16,7 mm (20-90 mm). Thời gian theo dõi trung bình 403,69 ± 279,29 ngày. Tỷ lệ ung thư giai đoạn sớm 58,82%(30/51). Tỷ lệ cắt bỏ nguyên khối trên nội soi (en-bloc) 48/51 (94,12%) và enbloc trên mô bệnh học là 45/51 (88.24%). Tỷ lệ thủng trong phẫu thuật và chảy máu chậm là 0% (0/41). Không quan sát thấy tái phát ở bất kỳ bệnh nhân nào trong thời gian theo dõi từ 3 đến 27 tháng. Kết luận: ESD là phương pháp hiệu quả và an toàn điều trị ung thư đường tiêu hóa giai đoạn đầu hoặc tổn thương tiền ung thư.To evaluate the efficacy and safety of endoscopic submucal dissection in the treatment of precancerous lesions and early gastrointestinal cancers at Tam Anh General Hospital in Hanoi for 3 years from 12/2021 to 05/2024. Methods: The clinical data of patients were retrospectively collected and analyzed. Inclusion criteria of the study were patients who underwent ESD
patients who were diagnosed with earlystage cancer or precancerous lesions in the gastrointestinal tract. Results: 41 patients were enrolled from December 2021 to 2024. Male/female ratio: 1,6/1, average age 65,06 ± 9,90 (36 to 83 years). Lesion features: 4 lesions were located in the esophagus, 15 lesions in stomach and 32 lesion was in the colon. The mean tumor size was 42,1 ± 16,7 mm, the resected lesion size ranged from 20 to 90 mm. The complete endoscopy en-bloc, and histology en bloc rates were 48/51 (94,12%), 45/51 (88.24%), respectively. The rate of earlystage cancer is 58,82% (30/51). The rate of intraoperative perforation and delayed bleeding was 0% (0/41). During the follow-up after treatment, none of the patients was diagnosed with local or distant recurrence. None of the patients died of carcinoma. Conclusions: Our results showed the feasibility and safety of endoscopic submucosal dissection for treating gastrointestinal early-stage cancer or precancerous lesions.

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