内镜黏膜下剥离术和内镜隧道剥离治疗对胃异位胰腺的临床价值  

The evaluation of endoscopic submucosal dissection and endoscopic tunnel dissection in the treatment of gastric ectopic pancreas

作　　者：冯姝婷[1] 由继辉[1] 李艳[1] 

机构地区：[1]辽宁省人民医院消化科,沈阳110016

出　　处：《检验医学与临床》2017年第14期2036-2037,2041,共3页Laboratory Medicine and Clinic

摘　　要：目的比较内镜黏膜下剥离术和内镜隧道剥离术治疗胃异位胰腺的临床价值。方法取该院检查疑为胃异位胰腺患者64例,分为2组,内镜黏膜下剥离术(ESD)32例(ESD组),内镜隧道剥离术(ESTD)32例(ESTD组)。比较2组患者剥离时间、剥离面积、一次完整切除率、术后并发症(穿孔、出血、边缘残留)等发生情况。结果 ESTD组患者手术剥离时间、患者住院时间少于ESD组患者,差异有统计学意义(P<0.05);ESTD组剥离面积、最长径向、完整切除率均大于ESD组,差异有统计学意义(P<0.05)。术后ESD组患者边缘残留、出血、穿孔发生率均高于ESTD组,差异有统计学意义(P<0.05)。ESTD组患者1例出院后1年复发,ESD组患者出院后2例复发,经内镜治疗后1年内未复发。结论 ESTD与ESD是治疗胃异位胰腺病变的有效方法。与ESD比较,ESTD具有操作时间短、剥离面积大等优势,在剥离大面积病变时可优先选择。Objective To explore the evaluation of endoscopic submucosal dissection and endoscopic tunnel dissection in the treatment of gastric ectopic pancreas.Methods A total of 64 cases of suspected gastric heterotopic pancreas were selected and divided into two groups,32 cases were performed endoscopic submucosal dissection （ESD）,and 32 cases were performed endoscopic tunnel dissection （ESTD）,the time of stripping,stripping area,the complete resection rate,postoperative complications （perforation,bleeding,edge residues）,were compared between the two groups.Results The time of operation and the hospitalization time of patients in group ESTD were less than that in group ESD,and the differences were statistically significant （P〈0.05）;The stripping area,the longest radial and the complete resection rate in ESTD group were higher than that in ESD group,and the differences were statistically significant （P〈0.05）.The incidence of residual,bleeding and perforation in ESD group were higher than that in ESTD group,the differences were statistically significant（P〈0.05）.There was one case of recurrence in ESTD patients,and two patients in group ESD had recurrence after discharge for one year,the three patients were improved after endoscopic treatment.Conclusion ESTD and ESD are effective methods for the treatment of gastric heterotopic pancreatic lesions.ESD has the advantages of short operation time,large stripping area with comparing with ESTD.In the treatment of large area of the lesion,ESTD could be a priority choice.

关 键 词：胃异位胰腺 内镜黏膜下剥离 内镜隧道剥离术 

分 类 号：R735.37[医药卫生—肿瘤]