食管黏膜下肿瘤的超声内镜诊断与内镜下微创治疗  

Endoscopic ultrasonography in diagnosis and minimally invasive treatment of esophageal submucosal tumors

作　　者：宁琳洪[1] 王雷[1] 樊超强[1] 任玮[1] 张霞[1] 凌贤龙[1] 赵晓晏[1] 郭红[1] 

机构地区：[1]第三军医大学新桥医院消化内科,重庆400037

出　　处：《第三军医大学学报》2011年第19期2055-2057,共3页Journal of Third Military Medical University

摘　　要：目的评价超声内镜对食管黏膜下肿瘤的诊断及治疗价值,探讨内镜微创治疗食管黏膜下肿瘤的有效性和安全性。方法经胃镜和超声内镜检查后诊断为起源于食管黏膜肌层肿瘤患者54例,直径≤1.0 cm的采用内镜下高频电圈套切除术,直径>1.0 cm的采用内镜黏膜下剥离术切除肿瘤。结果 54例患者均完全切除。病理组织学显示食管平滑肌瘤48例,淋巴管瘤3例,囊肿1例,均来源于黏膜肌层,间质瘤2例来源于固有肌层。1例术中发生创面出血,经高频电凝止血立刻停止,未发生其他与手术相关的并发症。术后6个月随访,所有患者创面均形成白色溃疡瘢痕。结论超声内镜辅助下内镜微创手术切除来源于黏膜肌层的食管黏膜下肿瘤是安全有效的治疗方法。Objective To evaluate the diagnostic and therapeutic value of endoscopic ultrasonography and to explore the safety and efficacy of endoscopic therapy in treatment of esophageal submucosal tumors.Methods Fifty-four patients who were diagnosed as esophageal submucosal tumor by gastroscopy and endoscopic ultrasonography were enrolled.High frequency electric trapped resection was applied to remove esophageal submucosal tumors with diameters less than 1.0 cm,and endoscopic submucosal dissection was applied to remove tumors bigger than 1.0 cm.Results The esophageal submucosal tumors of the 54 patients were completely resected.Histopathological and immunohistochemical examinations confirmed 48 patients of leiomyomas,3 patients of angiolymphomas and 1 patient of esophageal cyst,which were all originated from the mucous muscularis layer;2 patients were interstitialomas originated from the muscular propria layer;1 patient had intraoperative bleeding that was stopped by electrocoagulation hemostasis.No other operation-related complications occurred.After 6 months follow-up,endoscopy showed that the white ulcerous scars formed in all patients.Conclusion Endoscopic therapy assisted with endoscopic ultrasonography is a safe and effective treatment for resecting esophageal submucosal tumors originated from mucous muscularis layer.

关 键 词：黏膜下肿瘤 超声内镜 内镜治疗术 

分 类 号：R730.41[医药卫生—肿瘤] R730.56[医药卫生—临床医学]