超声内镜辅助套扎切除胃固有肌层来源小间质瘤的临床研究  

EUS-assisted endoscopic trepanned resection-closure of small gastric stromal tumors originating from the muscularis propria layer

作　　者：谢巧玉[1] 张德强[1] 王胜炳[1] 林小凤[1] 曾德辉[1] 杨智炜[1] 汪福群[1] 陈嘉瑜[1] 

机构地区：[1]广东省梅州市人民医院消化内科,514031

出　　处：《中华消化内镜杂志》2016年第10期672-675,共4页Chinese Journal of Digestive Endoscopy

基　　金：梅州市科技计划项目（20138135）

摘　　要：目的评价超声内镜辅助套扎切除治疗胃固有肌层来源小间质瘤的安全性及疗效。方法61例接受超声内镜指导下套扎切除术治疗的胃固有肌层来源的小间质瘤患者纳入回顾性研究，汇总手术完成情况、并发症发生情况及随访结果等。结果61例病变直径在5-12 mm，均采用胃壁全层切除方式一次性完整切除病变，手术时间25-45 min，术中切口穿孔均应用钛夹预固定后成功闭合，术中仅发生极少量出血，术后无出血。术后住院5-7 d，病理回报均为极低或低度恶性间质瘤。随访1-27个月，均未见病变残留和复发。结论超声内镜辅助下的套扎切除术治疗胃固有肌层来源的小间质瘤安全、有效，符合完整切除的治疗原则，还可获得完整的病理资料。Objective To evaluate the safety and effectiveness of EUS-assisted endoscopic trepanned resection-closure of small gastric stromal tumors originating from the muscularis propria layer. Methods Data of 61 patients with small gastric stromal tumors originating from the muscularis propria layer treated by EUS-assisted endoscopic trepanned resection-closure were retrospectively studied for operation completion, complication and follow-up results. Results All 61 patients with lesions of 5 to 12 mm in diame- ter achieved complete excision in one procedure by gastric wall full-thickness resection, with operation time of 25-45 min. Perforation was successfully closed with titanium clips after fastened in advance with only minor hemorrhage during surgery, and no hemorrhage occurred after the operation. The average length of hospitalization was 5-7 days. Pathology confirmed 61 cases of extremely low-grade or low-grade malignant gastrointes- tinal stromal tumors. The patients were followed up for 1 to 27 months, and no tumor residue or recurrence was observed. Conclusion It is safe and effective to use EUS-assisted endoscopic trepanned resection-closure, which could not only get the accurate pathologic diagnosis but also meet requirement of complete exci- sion of small gastric stromal tumors originating from the muscularis propria layer.

关 键 词：恶性间质瘤 固有肌层 超声内镜 内镜辅助 胃壁 套扎 临床研究 治疗原则 

分 类 号：R735.2[医药卫生—肿瘤]