激素不同给药途径预防内镜黏膜下剥离术后食管狭窄的研究进展

Research Progress on Prevention of Esophageal Stricture after Endoscopic Submucosal Dissection by Different Hormone Administration Routes

摘要: 内镜黏膜下剥离术(endoscopic submucosal dissection, ESD)是近年来治疗消化道早期癌及癌前病变的一项应用较为广泛的微创手术，由于ESD不仅可以获得需要明确诊断的病变的完整病理组织，还可以在不改变食管解剖结构的情况下对病变进行治愈性切除，还具有创伤小、恢复快、花费少等优势，目前已经成为早期食管癌的首选治疗手段。但大面积食管ESD术后易发生狭窄，影响患者生活质量。因此，如何预防术后狭窄是食管癌患者在ESD术后需要关注的重点。目前常用的预防方法包括口服或病灶局部使用糖皮质激素、内镜下球囊扩张(endoscopic balloon dilation, EBD)、聚乙醇酸网片使用以及支架植入等。如何选择适宜的治疗策略是目前研究的重点。激素在预防食管ESD术后狭窄方面具有重要作用，本文主要通过查阅近年来发表的文献分析比较激素不同给药方式预防食管ESD术后狭窄方面的优缺点。

Abstract: Endoscopic submucosal dissection (ESD) is a widely used minimally invasive surgery in the treatment of early and precancerous lesions of digestive tract in recent years. Meanwhile, ESD can not only obtain the complete pathological tissues of the lesions that need to be clearly diagnosed, but also obtain the endoscopic submucosal dissection (ESD). In addition, it can also be cured without changing the anatomical structure of the esophagus, and has the advantages of fewer traumas, quick recovery and less cost, so it has become the preferred treatment for early esophageal cancer. However, a large area of esophageal ESD surgery is prone to stenosis, which affects the quality of life of patients. Therefore, how to prevent postoperative stenosis is the focus of attention of esophageal cancer patients after ESD. At present, the commonly used prevention methods include oral or local use of glucocorticoids, endoscopic balloon dilation (EBD), polyglycolic acid mesh and stent implantation. How to choose the appropriate treatment strategy is the focus of current research. Hormone plays an important role in preventing esophageal ESD stenosis after surgery. This paper mainly analyzed and compared the advantages and disadvantages of different hormone administration methods in preventing esophageal ESD stenosis after surgery by referring to the literature published in recent years.