经内镜黏膜下隧道肿瘤切除术和黏膜下肿瘤挖除术治疗固有肌层来源黏膜下肿瘤比较  

Comparison of endoscopic submucosal excavation and submucosal tunneling endoscopic resection for submucosal tumors from muscularis propria

作　　者：王璐 彭涛[1] 高慧茹 赵文月[1] 王燕燕 Wang Lu;Peng Tao;Gao Huiru(Department of Endoscopy,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院内镜中心,张家口075000

出　　处：《中华保健医学杂志》2022年第2期115-117,共3页Chinese Journal of Health Care and Medicine

基　　金：河北省2020年度医学科学研究课题(20200536)。

摘　　要：目的观察内镜黏膜下肿瘤挖除术(endoscopic submucosal excavation,ESE)和黏膜下隧道肿瘤切除术(submucosal tunneling endoscopic resection,STER)治疗起源于固有肌层的消化道黏膜下肿瘤(submucosal tumors,SMTs)的效果。方法回顾性收集2018年1月~2020年10月于河北北方学院附属第一医院内镜中心92例接受ESE和STER的固有肌层来源SMTs患者病历资料,根据手术方式分为ESE组43例、STER组49例,比较两组手术时间、住院时间,并对两组完整切除率、残留复发及并发症进行比较。结果两组完整切除率比较差异无统计学意义(P>0.05),ESE组手术时间短于STER组,住院时间长于STER组,差异有统计学意义(P<0.05)。两组总并发症发生率差异无统计学意义(P>0.05)),但ESE组术中穿孔率9.30%(4/43),高于STER组的0%(0/49),穿孔率差异有统计学意义(P<0.05))。术后随访14~37个月,两组残留率、复发率差异均无统计学意义(P>0.05))。结论ESE、STER均可有效治疗固有肌层来源的SMTs,完整切除率高,与ESE相比,STER可降低穿孔率,缩短住院时间。Objective To observe the effect of endoscopic submucosal tumor excavation(ESE)and submucosal tunnel resection(STER)in the treatment of submucosal tumors(SMTS)originating from the muscularis propria.Methods Patients with SMTs from muscularis propria who received ESE and STER in the endoscopy center of our hospital from January 2018 to October 2020 were collected.The operation time and hospital stay were compared between the two groups,and the complete resection rate,residual recurrence and complications were compared between the two groups.Results There was no significant difference in complete resection rate between the two groups(P>0.05).The operation time in ESE group was shorter than that in STER group,and the hospital stay was longer than that in STER group.There was significant difference between the two groups(P<0.05).There was no significant difference in the incidence of total complications between the two groups(P>0.05),but the intraoperative perforation rate in ESE group was 9.30%,which was higher than 0%in STER group.There was significant difference in the perforation rate between the two groups(P<0.05).There was no significant difference in residual rate and recurrence rate between the two groups(P>0.05).Conclusion Both ESE and STER can effectively treat gastrointestinal submucosal tumors derived from muscularis propria,and the complete resection rate is high.Compared with ESE,STER can reduce the perforation rate and shorten the hospital stay.

关 键 词：消化道黏膜下肿瘤 固有肌层 黏膜下肿瘤挖除术 黏膜下隧道肿瘤切除术 

分 类 号：R735[医药卫生—肿瘤]