经黏膜下隧道内镜肿瘤切除术治疗上消化道黏膜下肿瘤的效果及安全性研究  

Efficacy and safety of submucosal tunnel endoscopic tumor resection in the treatment of upper gastrointestinal submucosal tumors

作　　者：林廷辉[1] 钟玉全[1] 张方宇[1] LING Tinghui;ZHONG Yuquan;ZHANG Fangyu(Department of Gastroenterology,the First People's Hospital of Neijiang,Neijiang 641000,China)

机构地区：[1]内江市第一人民医院消化内科,四川内江641000

出　　处：《中国肿瘤外科杂志》2021年第4期377-379,共3页Chinese Journal of Surgical Oncology

基　　金：四川省中医药管理局科学技术研究专项课题(2020JC0056)。

摘　　要：目的探讨经黏膜下隧道内镜肿瘤切除术(STER)治疗上消化道黏膜下肿瘤(SMT)的安全性及有效性。方法回顾分析2014年1月至2018年12月在内江市第一人民医院消化内镜中心接受STER治疗的SMT患者80例。在SMT上方3~5 cm建立黏膜下隧道,然后行内镜下剥离术,切除肿瘤后,采用金属夹封闭隧道入口。结果 80例患者均顺利完成STER,手术时间61.2(25~160)min。共切除SMT 83个,其中位于食管63个,贲门20个;起源于浅MP层63个,深MP层20个。病理组织学诊断为肌瘤68个,腺瘤15个。肿瘤长径平均23.2(10.0~55.0)mm, 13例长径≥35 mm, 81个肿瘤获整块切除。并发症发生率为8.8%(7/80),经对症治疗后均缓解。平均随访10.2个月未见肿瘤复发。结论 STER是一种可行、安全、有效的治疗上消化道SMT的方法。即使肿瘤长径>35 mm, STER仍然是一种有效的治疗手段。Objective To investigate the safety and efficacy of submucosal tunneling endoscopic resection(STER) in the treatment of submucosal tumor(SMT). Methods From January 2014 to December 2018, 80 patients with SMT who received STER in the Digestive Endoscopy Center of the First People’s Hospital of Neijiang City were selected. A submucosal tunnel was established 3-5 cm above the SMT, and then an endoscopic dissection was performed. After the tumor was removed, the entrance of the tunnel was sealed with a metal clip. Results All of the 80 patients successfully completed STER, the operation time was 61.2(25-160) min with an average. A total of 83 SMT were removed, including 63 in esophagus and 20 in cardia. There are 63 in shallow MP and 20 in deep MP. Histopathological diagnosis included 68 leiomyomas and 15 adenomas. The diameter of tumor was 23.2(10.0-55.0) mm, 13 cases were ≥35 mm in diameter, 81 tumors were treated by whole piece resection. The incidence of complications was 8.8%(7/80), which was relieved after symptomatic treatment. During an average follow-up of 10.2 months. Conclusions STER is a feasible, safe and effective method for the treatment of upper gastrointestinal SMT tumor. Even if the tumor diameter is more than 35 mm, STER is still an effective treatment.

关 键 词：胃肠道内镜手术 黏膜下肿瘤 经黏膜下隧道内镜肿瘤切除术 

分 类 号：R735[医药卫生—肿瘤]