内镜黏膜下剥离术治疗胃固有肌层肿瘤效果观察  

Clinical Effect of Endoscopic Submucosal Decollement in Treatment of Gastric Muscularis Propria Tumor

作　　者：谢健[1] 

机构地区：[1]张家港市第一人民医院消化内科,江苏张家港215600

出　　处：《解放军医药杂志》2015年第11期81-84,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨内镜黏膜下剥离术治疗胃固有肌层肿瘤的效果。方法选择张家港市第一人民医院消化内科2013年6月—2015年5月收治的54例胃固有肌层肿瘤患者作为研究对象,根据患者手术意愿分为内镜剥离组与腹腔镜切除组,每组27例。内镜剥离组采用内镜黏膜下剥离术切除肿物,腹腔镜切除组采用腹腔镜切除术切除肿物,对比分析两组术中及术后情况、术后并发症发生情况、预后,并在术前和术后2个月对患者进行生存质量评价。结果与腹腔镜切除组比较,内镜剥离组手术时间短、术中出血量少、切除病变直径小、住院时间短、并发症发生率低,差异均有统计学意义(P<0.05);术后2个月生活质量总分两组均明显高于术前(P<0.05),内镜剥离组术后2个月生活质量总分明显高于腹腔镜切除组(P<0.05);两组肿瘤均完整切除,病理报告肿瘤切缘及基底均为阴性;术后3、6、12个月进行随访,胃镜下观察切口均愈合良好,未发现一例肿瘤残留或复发。结论内镜黏膜下剥离术治疗胃固有肌层肿瘤有效安全,患者创伤小、恢复快的同时还可达到根治的目的。Objective To investigate the effect of endoscopic submucosal decollement in treatment of gastric muscularis propria tumor. Methods A iota1 of 54 patients diagnosed as having gastric muscularis propria tumor during June 2013 and May 2015 were recruited in this study, and were divided into endoscopic decoUement group （n =27 ） and laparoscopic resection group （n = 27 ） depending on the decision of the patients. The tumors in endoscopic decollement group were removed using endoscopic submueosal decollement, while the tumors in laparoscopic resection group were re- moved using laparoscopic resection. The intraoperative and postoperative conditions, incidence rates of postoperative com- plications and prognosis in the two groups were compared, and the quality of life before and 2 months after the surgery was evaluated. Results Compared with those in laparoscopic resection group, in endoscopic decol]ement group, the surgery time was significantly shorter, intraoperative blood loss was significantly less, diameters of excisiona] lesions were smal- ler, and the incidence rate of complications was significantly lower （ P 〈 0. 05 ） ; the total scores of quality of life in the two groups 2 months after the surgery were significantly higher than those before the surgery （P 〈 0. 05 ） , and the score in the endoscopic decollement group was significantly higher that that in the laparoscopic resection group （ P 〈 0. 05 ） ; tumors in the two groups were completely removed, and pathological results showed that cutting edge and basement were all negative; with follow-up in 3rd , 6＇h and 12th month after the surgery, incisions healed well under the gastroscope, and no residual tumor or recurrence was found. Conclusion The endoscopic submucosa] decollement in treatment of gastric muscnlaris propria tumor is effective and safe with micro invasion and better recovery.

关 键 词：胃固有肌层肿瘤 内镜黏膜下剥离术 腹腔镜 并发症 

分 类 号：R735.2[医药卫生—肿瘤]