金属夹牙线体外牵引在胃底固有肌层肿物内镜下全层切除中的应用价值  

Clinical value of dental floss clip traction in endoscopic full-thickness resection for muscularis propria tumor in gastric fundus

作　　者：叶院宁 郭玲玲 魏绮丽 李抗抗[1] 陈锦凤[1] 李爱民[2] YE Yuanning;GUO Lingling;WEI Qili;LI Kangkang;CJinfeng;LI Aimin(Department of Gastroenterology,Nanfang Hospital Zengcheng Campus,Southern Medical University,Guangzhou 511300,China)

机构地区：[1]南方医科大学南方医院增城院区消化内科,511300 [2]南方医科大学南方医院消化内科,510515

出　　处：《现代消化及介入诊疗》2024年第11期1277-1280,1293,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：国家自然科学基金(82373165)。

摘　　要：目的探讨金属夹牙线体外牵引辅助技术在胃底固有肌层肿物内镜下全层切除术(EFTR)中的临床效果。方法回顾性分析2020年7月至2023年7月南方医科大学南方医院增城院区278例1~3 cm胃底固有肌层肿物并行EFTR治疗患者的临床资料,根据术中是否使用金属夹牙线体外牵引分为牵引组(135例)和非牵引组(143例)。比较两组的手术时间、穿孔时间、术中及术后并发症情况等指标,对患者进行术后随访,评价两组患者治疗效果。结果278例患者均成功完成EFTR治疗,病变均为一次性完整切除。牵引组手术时间、穿孔时间分别为(30.61±15.43)min、(20.33±8.92)min;显著短于非牵引组的(40.84±20.12)min、(35.24±10.51)min(P均<0.05)。牵引组术中出血发生率为5.92%,显著低于非牵引组的11.90%(P=0.008)。牵引组术中出现气腹发生率为2.22%,显著低于非牵引组的14.69%(P<0.001);所有气腹患者术中经无菌注射器腹腔穿刺排气后缓解。牵引组短暂性发热发生率为2.69%,显著低于非牵引组的7.00%(P=0.023)。两组患者术后均未出现迟发性出血、穿孔及腹膜炎等并发症。两组住院时间比较差异无统计学意义(P=0.232)。两组患者术后随访12~36个月,平均随访时间为(25.60±10.52)个月,均未出现肿瘤复发转移情况。结论金属夹牙线体外牵引辅助技术可以明显缩短1~3 cm胃底固有肌层肿物EFTR的手术时间及穿孔时间,可明显减少手术相关并发症,可以获得较好的临床效果。Objective To investigate the clinical effect of dental floss clip traction(DFC)technology in endoscopic full-thickness resection(EFTR)of muscularis propria tumor in gastric fundus.Methods A total of 278 patients who diagnosed with 1~3 cm gastric fundus muscularis propria tumor and treated with EFTR in our hospital from July 2020 to July 2023 were retrospectively analyzed.They were divided into DFC group and non-DFC group.The operation time,perforation time,intraoperative and postoperative complications and other indexes were compared between the two groups,The patients were followed up after surgery to evaluate the treatment effect of the two groups.Results All 278 patients were successfully completed with EFTR treatment,and all lesions were completely resected at one time.In the DFC group,the operation time and perforation time were(30.61±15.43)minutes and(20.33±8.92)minutes,respectively,which was significantly shorter than(40.84±20.12)minutes and(35.24±10.51)minutes in the non-DFC group(P<0.05).The incidence of intraoperative bleeding in DFC group was 5.92%,which was significantly lower than that in non-DFC group(11.90%,P=0.008).The incidence of pneumoperitoneum in DFC group was 2.22%,significantly lower than that in non-DFC group(14.69%)(P<0.001),all patients with pneumoperitoneum were relieved after intraoperative abdominal puncture and exhaust with sterile syringes.The incidence of transient fever in DFC group(2.69%)was significantly lower than that in non-DFC group(7.00%)(P=0.023).There were no complications such as delayed bleeding,delayed perforation and peritonitis in the two groups.There was no significant difference in hospital stay between the two groups(P=0.232).The patients in the two groups were followed up for 12-36 months after operation,with an average follow-up time of(25.60±10.52)months,no tumor recurrence and metastasis occurred.Conclusion The assisted DFC technology can significantly shorten the operation time and perforation time of EFTR for 1~3 cm muscularis propria tumor in gastric f

关 键 词：金属夹牙线牵引 胃底固有肌层肿物 内镜下全层切除术 

分 类 号：R573[医药卫生—消化系统]