食管固有肌层平滑肌瘤黏膜下隧道法内镜剥离切除治疗探讨  

Submucosal tunneling endoscopic resection for esophageal leiomyoma originating from muscularis propria

作　　者：赵志峰[1] 麻树人[1] 张宁[1] 杨卓[1] 宫照杰[1] 金晓龙[1] 施阳[1] 张莉[1] 石戈[1] 

机构地区：[1]沈阳军区总医院内窥镜科,沈阳110840

出　　处：《中华消化内镜杂志》2012年第5期251-254,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨黏膜下隧道法内镜切除治疗食管固有肌层平滑肌瘤的临床效果。方法2011年1月至11月问胃镜及超声内镜检查确诊食管固有肌层肿物的患者，按照知情同意的原则选择性参加本组研究。16例患者入组并完成了研究计划。入组病例采用内镜经食管黏膜下隧道切除病变，并且术后行病理检查和跟踪随访观察。结果食管固有肌层肿物完整切除率100％，术后均病理学检查证明为平滑肌瘤，病理免疫组化提示增生活跃9例。术中并发纵隔、皮下、腹膜后气肿1例，1周后自行恢复，无其他并发症及相应病例，无死亡病例。平均随访观察半年，无复发病例。结论黏膜下隧道法内镜切除治疗食管固有肌层平滑肌瘤是微创、安全有效的治疗方法。Objective To retrospectively evaluate the clinical efficacy of endoscopic submucosal tunnel resection for esophageal leiomyoma originating from muscularis propria. Methods A total of 16 patients with esophageal mass originating from muscularis propria were recruited with informed consents from January 2011 to November 2011, and underwent esophageal submueosal tunneling endoscopic resection. Results All lesions were completely resected. Histological examinations confirmed the diagnosis of leiomyoma, and immunohistoehemieal staining indicated active hyperplasia in 9 cases. Intraoperative mediastinal, subcu- taneous and retroperitoneal emphysema occurred in one patient, and the patient recovered one week later. No other complications or death were recorded. The patients were followed up for six months on average, and no cases of recurrence were found. Conclusion Endoscopic submucosal tunnel resection of esophageal leiomyoma originating from the muscularis propria is a minimally invasive, safe and effective procedure.

关 键 词：平滑肌瘤 食管 固有肌层 内镜黏膜下隧道切除术 

分 类 号：R735.1[医药卫生—肿瘤]