内镜黏膜下剥离术治疗胃间质瘤的远期疗效研究  

Long-term outcomes of endoscopic submucosal dissection for gastric stromal tumors

作　　者：於常吉 樊超强[1] 于劲[1] 谢霞[1] 聂绪彪 刁鑫伟[1] 刘恩[1] 柏健鹰[1] 杨仕明[1] 

机构地区：[1]第三军医大学新桥医院消化科,重庆400037

出　　处：《局解手术学杂志》2016年第4期279-282,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市科技攻关项目(cstc2015shmszx120010)

摘　　要：目的探讨内镜黏膜下剥离术（ESD）治疗胃间质瘤的远期疗效。方法回顾性研究25例在我院行ESD治疗的胃间质瘤患者的临床资料,归纳分析其临床特征、病理结果、并发症及远期疗效。结果 25例患者均一次性完整切除病变,病变直径0.6~7.6 cm,平均3.0 cm。手术时间15~154 min,平均65 min。1例术中出血200 m L,予止血钳成功止血。4例发生术中穿孔,穿孔率16%,均采用金属钛夹成功关闭。1例切除肿瘤过大,取出时致食道黏膜机械性撕裂伤。术后住院时间为4~21 d,平均7.3 d。术后随访13~54个月,平均30个月,均未见肿瘤复发及远处转移。结论内镜黏膜下剥离术治疗胃间质瘤远期有效,可作为无远处转移的胃间质瘤的治疗方法。Objective To explore the long-term outcomes of endoscopic submucosal dissection（ ESD） of gastric GISTs. Methods Data of25 patients with gastric stromal tumors,who underwent ESD,were reviewed in terms of clinical characteristics,histopathologic results,complications and long-term outcomes. Results Twenty-five patients underwent one-time complete removal of lesion,with a average tumor size of 3. 0 cm（ range,0.6 to 7.6 cm）. The average time of operation was 65 minutes（ range,15 to 154 minutes）. one case was observed with intraoperative hemorrhage of 200 m L blood,which was successfully managed by hemostatic forceps. Perforation with incidence rate of 16% occurred in 4 cases and was closed well with clips. Mucosal mechanical laceration of esophagus occurred in 1 case when the big tumor was taken out. The average length of hospitalization was 7. 3 days（ range,4 to 21 days）. A follow-up for 30 months（ range,13 to 54 months） showed no tumor recurrence or metastasis.Conclusion ESD is an effective and safe endoscopic procedure to remove gastric GISTs for long-term outcomes in patients with no metastasis.

关 键 词：胃间质瘤 内镜黏膜下剥离术 远期疗效 

分 类 号：R735.2[医药卫生—肿瘤]