食管黏膜下肿瘤内镜下多环黏膜套切术的疗效和安全性分析  

Efficacy and safety of the duette multiband mucosectomy for esophageal submucosal tumors

作　　者：周玉保[1] 周华邦[1] 张道权[1] 金树[1] 詹翔[1] 谢菁[1] 胡冰[2] 

机构地区：[1]安徽医科大学第二附属医院消化内镜科,合肥230601 [2]第二军医大学东方肝胆外科医院内镜科

出　　处：《中华消化内镜杂志》2015年第5期313-316,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨内镜下多环黏膜套切术（EMBM）治疗食管黏膜下肿瘤的安全性及疗效。方法将2012年1月至2014年8月51例食管黏膜下肿瘤患者（52处病变，来源于黏膜肌层或黏膜下层，直径均≤2．0cm）的临床资料纳入回顾性研究，其中行EMBM治疗者33例（34处病变，EMBM组）、内镜黏膜下切除术（ESMR）治疗者18例（18处病变，ESMR组），对比分析操作成功率、完整切除率、操作时间、并发症及随访情况的组间差异。结果51例均成功施行内镜治疗，无一例出现穿孔、感染及术后大量出血，术后随访均未见复发。但与ESMR组相比，EMBM组完整切除率更高[97．1％（33／34）比61．1％（11／18），P=0．010]、操作时间更短[（6．3±1．8）min比（21．4±3．8）min，P=0．001]、并发症发生率更低[6．1％（2／33）比27．8％（5／18），P=0．024]。结论来源于黏膜肌层或黏膜下层，直径≤2．0cm的食管黏膜下肿瘤行EMBM治疗简单、安全和有效。Objective To investigate clinical efficacy and safety of endoscopic multiband mucosectomy （EMBM） for esophageal submucosal tumors （SMTs）. Methods Data of 51 patients with SMTs diagnosed between Jan 2012 and Aug 2014 were retrospectively studied. Of the 51 patients, 33 patients （34 lesions） received EMBM and 18 patients received endoscopic submueosal resection （ESMR）. The operation success rates, complete resection rates, procedure time, complications and the follow-up of group EMBM and group ESMR were compared. Results All of 51 cases had successful endoscopic treatment with no perforation, infection or obvious bleeding. Follow-up showed no recurrence after operation. Compared with group ESMR, group EMBM had higher complete resection rate [ 97.1% （ 33/34 ） VS 61.1% （ 11/18 ）, P = 0. 010], shorter operation time[ （6. 3 ± 1.8）min VS （21.4 ±3.8）min,P =0. 001 ] and lower complication rate[6. 1% （2/33） VS 27.8% （5/18） ,P =0. 024]. Conclusion EMBM is simple, safe and effective for treating SMTs originating from muscularis mucosa or submucosa which are less than 2. 0 cm in diameter.

关 键 词：食管 黏膜下肿瘤 内镜下多环黏膜套切术 内镜黏膜切除术 

分 类 号：R735.1[医药卫生—肿瘤]