保留功能的胃贲门区黏膜下肿瘤微创化治疗  

Minimally invasive treatment with function preservation for submucosal tumors in the gastric cardia

作　　者：刘天舟[1] 田振纬 朱甲明[1] Liu Tianzhou;Tian Zhenwei;Zhu Jiaming(Department of Gastrointestinal Surgery,the Second Affiliated Hospital of Jilin University,Changchun,Jilin 130041,China;Department of Intensive Care Unit,the Second Affiliated Hospital of Jilin University,Changchun,Jilin 130041,China)

机构地区：[1]吉林大学第二医院胃肠外科,长春130041 [2]吉林大学第二医院ICU科,长春130041

出　　处：《中华胃肠外科杂志》2020年第10期944-948,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：吉林省科技发展计划项目 (20200708108YY、20180101169JC)。

摘　　要：胃贲门区黏膜下肿瘤检出率逐年上升,多数为良性或者交界性肿瘤,其中平滑肌瘤、胃肠间质瘤较为常见。贲门区的功能保留与食管胃结合部区域的解剖结构密切相关,其中防止食管反流这一功能的评价主要通过上消化道造影、胃镜、CT和食管下段括约肌压力测定等方法直接或间接评价。这个特殊解剖部位的肿瘤,淋巴结转移风险很低,遵循无瘤原则,通常只需完整切除肿瘤即可。本文旨在介绍胃贲门区黏膜下肿瘤功能保留的微创化治疗方法,包括单纯内镜下治疗、内镜和腹腔镜联合手术及完全腹腔镜手术。这些治疗方法要根据肿瘤位置、大小、形态、生长方式(胃腔内或外)及手术团队水平等情况进行个体化的选择。The detection rate of submucosal tumors in the gastric cardia increases year by year.Most of these tumors are benign or borderline tumors,among which leiomyoma and gastrointestinal stromal tumor are more common.The functional preservation of the gastric cardiac region is closely related to the anatomical structure of the esophagogastric junction.The esophageal reflux is mainly evaluated directly or indirectly by upper gastrointestinal radiography,gastroscopy,CT examination and manometric measurements of the lower esophagus.For tumors at this specific region,the risk of lymph node metastasis is very low,and according to the tumor free principle,usually only complete removal of the tumor is required.We aim to introduce the minimally invasive and function preserving procedures,including endoscopic therapy alone,laparoscopic and endoscopic cooperative surgery,and totally laparoscopic surgery.The selection of this tailored treatment should be based on the tumor location,size,shape and growth pattern(intraluminal or extraluminal),and the experience of the surgical team,so as to improve postoperative quality of life of the patients.

关 键 词：黏膜下肿瘤 保留功能 微创化治疗 

分 类 号：R735.2[医药卫生—肿瘤]