透明帽法切除食管上段颗粒细胞瘤1例  

Cap-assisted endoscopic mucosal resection of a granulosa cell tumor of the upper esophagus

作　　者：谢宏民[1] 杨新魁[1] 

机构地区：[1]广东医学院附属中山医院消化内科,广东省中山市528415

出　　处：《世界华人消化杂志》2014年第31期4890-4892,共3页World Chinese Journal of Digestology

摘　　要：1例28岁的女子因为上腹闷痛入院,伴有吞咽困难.超声内镜检查示:距门齿20 cm食管后壁见一黏膜下隆起,大小约0.5 cm×0.6 cm,表面光滑,超声探头扫查食管示,病变位于黏膜肌层.切面大小约2.5 mm×3.2 mm.内部呈不均匀低回声.黏膜下层和固有肌层清晰完整.使用透明帽法合并内镜下黏膜切除术(endoscopic mucosal resection,EMR)切除肿物.组织学检查证实为完整切除肿瘤.临床过程很顺利,6 wk后复查胃镜显示完全切除肿瘤.目前颗粒细胞瘤的治疗主张EMR行黏膜下切除.食管上段的肿物视野不佳,操作过程中易出现咽喉水肿,操作失败等,内镜下透明帽辅助食管上段颗粒细胞瘤理论上更有效、更安全.A 28-year-old woman was admitted for pain in the upper abdomen accompanied with dysphagia. Endoscopic ultrasonography showed submucosal protrusion measuring 0.5 cm × 0.6 cm in the posterior wall of the esophagus 20 cm away from incisor teeth. Scanning of the esophagus with an ultrasonic probe shows that the lesion was located in the muscularis mucosa with a section size of 2.5 mm × 3.2 mm. Heterogeneous hypoecho was noted inside the tumor, while the submucosa and muscularis propria were clear and complete. The tumor was excised by cap-assisted endoscopic mucosal resection（EMRC）. Postoperative pathological analysis demonstrated that the tumor was excised completely. The clinical course was uneventful, and gastroscopy showed that the tumor was excised completely 6 wk after surgery. Submucosal excision by EMR has been proposed in current therapy of granulose cell tumors. Since the view of tumors in the upper esophagus is not good, throat edema, operation failure and other complications may easily occur. Therefore, adjunctive therapy by EMRC for granulose cell tumors of the upper esophagus is much effective and safe.

关 键 词：透明帽吸引法黏膜切除术 食管颗粒细胞瘤 内镜下黏膜切除术 

分 类 号：R735.1[医药卫生—肿瘤]