内镜黏膜下剥离术治疗胃良性肿瘤的临床疗效  

Clinical effect of endoscopic submucosal dissection for gastric benign tumors

作　　者：武育卫[1] 胡文华[1] 师雷峰 王仰坤[1] 何双丽 

机构地区：[1]解放军150医院消化内科,河南洛阳471031

出　　处：《实用医药杂志》2016年第11期980-982,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨内镜黏膜下剥离术（endoscopic submucosal dissection,ESD）治疗胃良性肿瘤的临床疗效。方法回顾性分析笔者所在医院于2013年1月—2015年12月术前通过活检明确病变性质或超声内镜判断病变浸润深度,对起源于黏膜层、黏膜肌层、黏膜下层共42例胃良性肿瘤患者行ESD治疗,3个月后复查内镜评估疗效。结果 36例完全切除,完全切除率85.7%（36/42）,ESD切除病变直径1.0-4.5 cm,8例术中少量出血,出血率19.0%（8/42）,经热活检钳电凝止血成功,无迟发性出血和穿孔。ESD术后病理：增生性息肉3例,绒毛状腺瘤4例,良性间质瘤17例,平滑肌瘤5例,脂肪瘤7例,异位胰腺6例。36例术后3个月胃镜随访,无残留和复发。结论ESD术治疗胃良性肿瘤安全、有效,并可提供准确病理资料。Objective To explore the efficacy of endoscopic submucosal dissection（ESD） for gastric benign tumors. Methods The 42 patients with gastric benign tumor who had received ESD treatment were retrospectively analyzed from January 2013 to December 2015 in author＇s hospital. The nature of the lesions from mucosa were detected by endoscopic biopsy before ESD,the infiltrated depth of the lesions from muscularis mucosa and submucosa were detected by endoscopic ultrasonography before ESD. All the patients were followed up with endoscopy 3 months after ESD. Results The 36 lesions were completely resected,the whole-lesion dissection rate was 85.7%（36/42）,all lesions sized 1.0-4.5cm in diameter,a small amount of intraoperative bleeding for 8 lesions was stopped by electrocoagulation hemostasis,the bleeding rate during ESD was 19.0%（8/42）,no delayed hemorrhage and perforation were found. Postoperative pathology revealed hyperplastic polyps in 3cases and villous adenomas in 4 cases and benign stromal tumors in 17 cases and leiomyomas in 5 cases and lipomas in 7 cases and ectopic pancreases in 6 cases. No residue or recurrence was found during the follow-up of 3 months. Conclusion ESD is a safe and effective endoscopic treatment method for gastric benign tumor,and it can provide exact pathological information.

关 键 词：内镜黏膜下剥离术 胃良性肿瘤 临床疗效 

分 类 号：R735.2[医药卫生—肿瘤]