经粘膜下隧道内镜肿瘤切除术治疗来源于固有肌层食管贲门粘膜下肿瘤临床效果观察  

Clinical value of submucosal tunneling endoscopic resection in submucosal tumors of the esophagus and cardia derived from the muscularis propria

作　　者：左海军[1] 江堤[1] 廖素环[1] 苏剑东[1] 乐有林 刘美红[1] 张卡[2] Hai-Jun Zuo;Di Jiang;Su-Huan Liao;Jian-Dong Su;You-Lin Le;Mei-Hong Liu;Ka Zhang(Gastroenterology Department,Dongguan Tungwah Hospital,Dongguan 523110,Guangdong Province,China;Department of Infectious Diseases,the Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,Guangdong Province,China)

机构地区：[1]东莞东华医院消化内科,广东省东莞市523110 [2]中山大学附属第三医院感染科,广东省广州市510630

出　　处：《世界华人消化杂志》2020年第14期643-649,共7页World Chinese Journal of Digestology

基　　金：东莞市社会科技发展项目,No.2018507150461228。

摘　　要：背景经粘膜下隧道内镜肿瘤切除术(submucosal tunneling endoscopic resection,STER)是近年出现治疗粘膜下肿瘤的新方法,该方法微创,并发症少,患者恢复快.本研究通过对我院实施该手术患者的病例资料统计分析,探讨该手术治疗粘膜下肿瘤的可行性、有效性及安全性.目的探讨STER治疗食管贲门粘膜下肿瘤的有效性、安全性及临床应用价值.方法收集我院消化科2018-03/2019-03间行STER的食管贲门粘膜下肿瘤病例60例.观察患者超声内镜诊断,手术成功率,术后并发症发生率,术后病理诊断,并进行统计学分析.结果所有患者均完成STER,手术成功率100%.粘膜下肿瘤直径1.0-5.0 cm,平均直径1.83 cm±1.37 cm.手术耗时31-123 min,平均耗时81.73 min±23.23 min.粘膜下隧道长度为4-8 cm,平均隧道长度为5.88 cm±1.17 cm.术前超声内镜:平滑肌瘤45例,间质瘤15例.术后病理:平滑肌瘤为42例,间质瘤18例.术后并发症发生率:2例出现皮下气肿,经内科保守治疗痊愈出院.患者住院时间为7-11 d,平均住院天数9.96 d±2.24 d.结论STER治疗来源于固有肌层的食管贲门粘膜下肿瘤疗效确切有效,并发症少,安全性高,值得临床推广应用.BACKGROUND Submucosal tunneling endoscopic resection(STER)is a new method for treating submucosal tumor in recent years,which is minimally invasive,with few complications and rapid recovery for patients.This study analyzed the data of patients who underwent this surgery at our hospital and explored the feasibility,effectiveness,and safety of this procedure for submucosal tumors.AIM To evaluate the efficacy,safety,and clinical value of STER in the treatment of submucosal tumors of the esophagus and cardia derived from the muscularis propria.METHODS Sixty patients who underwent STER for submucosal tumors of the esophagus and cardia derived from the muscularis propria were included.The results of endoscopic ultrasonography,procedure success rate,postoperative complications,postoperative pathological results,and postoperative follow-up data were recorded and analyzed statistically.RESULTS All of the cases completed the STER,with a success rate of 100%.The diameter of submucosal tumors was 1-5 cm.The operation took 31 to 123 min,and the average operation time was 81.73 min±23.23 min.The length of submucosal tunnel was 4-8 cm,with an average value of 5.88 cm±1.17 cm.Postoperative pathology confirmed that there were 42 cases of leiomyoma and 18 cases of stromal tumor.Two patients developed subcutaneous emphysema and right-side pneumothorax post operation,who were cured with conservative treatment.All cases were followed for 3 mo without any residual or recurrence of the lesion and no complications such as esophageal stenosis.CONCLUSION STER is effective in the treatment of submucosal tumors of the esophagus and cardia derived from the muscularis propria,with few complications and high safety.

关 键 词：粘膜下肿瘤 经内镜粘膜下隧道肿瘤切除术 固有肌层 

分 类 号：R735[医药卫生—肿瘤]