内镜黏膜下挖除术在黏膜下肿瘤中的应用  

Endoscopic Submucosal Excavation for Submucosal Tumors

作　　者：张秀华[1] 文卫[1] 范志宁[1] 王敏[1] 梁军才[1] 

机构地区：[1]南京医科大学第二附属医院消化医学中心,南京210011

出　　处：《中国微创外科杂志》2011年第3期237-239,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨内镜黏膜下挖除术（endoscopic submucosal excavation,ESE）处理消化道黏膜下肿瘤（submucosaltumor,SMT）的疗效和安全性。方法 2009年1~11月内镜发现的22例黏膜下病灶（食管11例、贲门2例、胃8例、结肠1例）作为入选对象,通过内镜超声（endoscopic ultrasonography,EUS）检查明确病灶大小、位置、性质,进行ESE治疗,观察其疗效和并发症情况。结果 20例（91%）完整挖除,2例ESE术后创面仍有肿瘤残留且病理报告低度恶性,转外科手术扩大切除治疗。病灶直径0.5~3.5 cm（平均1.5 cm）,手术时间20~220 min（平均75 min）。3例穿孔均保守治愈。术后随访1~12个月（平均6.5月）,20例完整挖除者均未见复发。结论 ESE对消化道的SMT具有可完整挖除病灶、创伤小、术后恢复快等优点,值得推广。Objective To assess the effectiveness and safety of endoscopic submucosal excavation（ESE） in the treatment of patients with submucosal tumor（SMT）. Methods Totally 22 patients with SMT in the gastrointestinal tract detected by endoscopy were enrolled into this study from January 2009 to August 2009.Endoscopic ultrasonography（EUS） were applied to confirm the size,location,and nature of the lesions.The patients were then treated by ESE,and the efficacy and complications were observed afterwards.Results In the 22 cases,the tumor was completely removed in 20 patients（91%） by ESE,the other two patients who had residual tumor tissues were confirmed with low malignancy and thus were converted to open surgery for extended resection.The mean size of lesions in our group was 1.5 cm（0.5-3.5 cm）,and the mean operation time for ESE was 75 min（20-220 min）.Three patients developed perforation during the procedure and were then cured by conservative therapy.A mean of 6.5-month follow-up（1-12 months） was achieved in the patients,during which the 20 patients who had the lesion removed completely had no recurrence.Conclusions ESE is a minimally invasive method with complete resection,minimal invasion and quick postoperative recovery.

关 键 词：内镜黏膜下挖除术 黏膜下肿瘤 消化道 治疗 

分 类 号：R735[医药卫生—肿瘤]