超声内镜辅助下内镜下黏膜切除对食管黏膜层上皮下病变的诊疗价值  

Therapeutic and diagnostic effects of ultrasound-assisted endoscopic mucosal resection of esophageal subepithelial lesion originating from muscularis mucosa

作　　者：曹付亮[1] 孙思予[1] 吕庆杰[1] 刘治军[1] 王国鑫[1] 郭瑾陶[1] 张秋楠[1] 许娜[1] 孙世伟[1] 

机构地区：[1]中国医科大学盛京医院内镜诊治中心,辽宁沈阳11004

出　　处：《中国内镜杂志》2009年第8期785-788,共4页China Journal of Endoscopy

摘　　要：目的探讨超声内镜辅助下内镜下黏膜切除对食管黏膜层上皮下病变的诊断、治疗价值及安全性。方法对该院2005年12月～2008年8月收治的48例经超声内镜诊断的51处食管黏膜层上皮下病变,予行内镜下黏膜切除治疗。结果51处病变均一次性完全切除,完全切除率达100%,术后无1例发生大出血及穿孔等并发症,随访41例(85.4%),平均随访(10.7±8.2)个月,均未见复发或转移。48例病例中有37例(77.1%)送病理及免疫组织化学检查,病理诊断食管间质瘤7例,平滑肌瘤25例,食管囊肿2例,血管瘤1例,鳞状上皮增生肥厚1例,淋巴管瘤1例。结论超声内镜辅助下内镜下黏膜切除对食管黏膜层上皮下病变的治疗是安全、有效的,并能获得完整病理诊断。[ Objective ] To evaluate the therapeutic and diagnostic effects and safety of ultrasound-assisted endoscopic mucosal resection of esophageal subepithelial lesion originating from muscularis mucosa. [Methods] From December 2005 to August 2008, 51 esophageal subepithelial lesions from muscularis mucosa of 48 patients, which were conformed by endoscopy and endoscopic uhrasonography （EUS） in our institution, were treated by ultrasoundassisted endoscopic mucosal resection. [Results] All lesions were totally reseeted and the success rate was 100%. Endoscopic hemostasis was necessary （and successful） in 4 patients （8.3%）, but blood transfusion was not required. No patients developed perforation or massive hemorrhage, and there were on other immediate postoperative complications. There were 41 patients （85.4%） under follow-up. During the mean prospective follow-up of （10.7±8.2） months （range： 1-33 months）, no recurrence or metastasis was found. Among the 48 patients, 37 patients obtained pathological and immunohistoehemical examinations revealing 7 esophageal stromal tumors, 24 leiomyomas, 2 esophageal cysts, 1 angioma, 1 squamous epithelial byperplasia and 1 lymphangioma. [ Conclusion ] Ultrasound-assisted endoscopic mueosal resection is feasible, effective and safe for the management of selected esophageal subepithelial lesions from museularis mucosa, and can offer histological diagnosis.

关 键 词：食管上皮下病变 食管间质瘤 内镜下黏膜切除 超声内镜 

分 类 号：R571[医药卫生—消化系统]