论著

内镜全层切除术治疗胃黏膜下小肿瘤的临床疗效分析

展开
  • 复旦大学附属中山医院内镜中心,上海 200032

收稿日期: 2020-07-09

  网络出版日期: 2022-08-03

基金资助

上海科学技术委员会科研计划项目(19DZ2280100)

Clinical effect of endoscopic full thickness resection in treatment of small gastric submucosal tumors

Expand
  • Department of Endoscopy, Zhongshan Hospital, Fudan Univesity, Shanghai 200032, China

Received date: 2020-07-09

  Online published: 2022-08-03

摘要

目的:研究内镜全层切除术治疗胃黏膜下小肿瘤(直径≤1 cm)的临床效果。方法:回顾性分析2015年1月至12月本院行内镜全层切除术治疗胃黏膜下小肿瘤的102例病人,观察肿瘤切除率、手术时间、术中出血、术后并发症发生情况。术后内镜随访,评价治疗效果与安全性。结果:102例均成功完成内镜治疗,肿瘤完整切除,平均手术时间(34.8±7.5)(11~126) min。病理检查结果肿瘤直径为(0.50±0.36)(0.3~1.0) cm,肿瘤均位于胃底。病理检查结果为,间质瘤51例(50.0%),平滑肌瘤45例(44.1%),纤维瘤2例(2.0%),神经内分泌肿瘤2例(2.0%),错构瘤1例(1.0%),淋巴瘤1例(1.0%)。所有病人均未发生出血及穿孔。术后随访期间所有病例胃创面愈合良好。结论:应用内镜全层切除术治疗胃黏膜下小肿瘤是安全、有效的。

本文引用格式

刘靖正, 任重, 胡健卫, 秦文政, 钟芸诗, 周平红 . 内镜全层切除术治疗胃黏膜下小肿瘤的临床疗效分析[J]. 外科理论与实践, 2021 , 26(03) : 236 -239 . DOI: 10.16139/j.1007-9610.2021.03.012

Abstract

Objective To evaluate the clinical efficacy of endoscopic full thickness resection in treatment of small gastric submucosal tumors (diameter≤1 cm). Methods A total of 102 patients with small gastric submucosal tumors treated using endoscopic full thickness resection in Zhongshan Hospital, Fudan University between January 2015 and December 2015 were analyzed retrospectively. Tumor resection rate, procedure time, interoperative bleeding and postoperative complications were observed in the procedures. Patients had follow-up endoscopy for evaluation of efficacy and safety. Results Endoscopic treatment was successful and resection of tumor was complete for all 102 patients. The average procedure time was (34.8±7.5) (11-126) min, Tumor diameter was (0.50±0.36) (0.3-1.0) cm and located all at gastric fundus. Pathological diagnose showed that 51 cases were with stromal tumor(50%), 45 cases with leiomyoma(44.1%), 2 cases with fibroma (2.0%), 2 cases with neuroendocrine tumors(2.0%), 1 case with hamartoma(1.0%), and 1 case with lymphoma(1.0%). Bleeding and perforation were not found and lesion surface of stomach was repaired well shown by follow-up. Conclusions Endoscopic full thickness resection in treatment of gastric submucosal tumors is effective and safe.

参考文献

[1] Chen T, Zhou PH, Chu Y, et al. Long-term outcomes of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors[J]. Ann Surg, 2017, 265(2):363-369.
[2] Zhang Q, Li Y, Meng Y, et al. Should the integrity of mucosa be considered in endoscopic resection of gastric submucosal tumors?[J]. Gastroenterology, 2016, 150(4):822-824.
[3] Choi CI, Lee SH, Hwang SH, et al. Various features of laparoscopic tailored resection for gastric submucosal tumors: a single institution's results for 168 patients[J]. Surg Endosc, 2016, 30(4):1450-1458.
[4] 严和中, 唐郡, 解传磊, 等. 超声内镜联合EMR及ESD诊治上消化道黏膜下肿瘤的效果[J]. 安徽医学, 2016, 37(1):38-40.
[5] Lv XH, Wang CH, Xie Y. Efficacy and safety of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors: a systematic review and meta-analysis[J]. Surg Endosc, 2016, 31(1):49-63.
[6] 周平红, 姚礼庆, 秦新裕, 等. 无腹腔镜辅助的内镜全层切除术治疗源于固有肌层的胃黏膜下肿瘤[J]. 中华消化内镜杂志, 2009, 26(12):617-621.
[7] Zhou PH, Yao LQ, Qin XY, et al. Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria[J]. Surg Endosc, 2011, 25(9):2926-2931.
[8] 任育宏, 张志强, 高鸿亮, 等. 经胃镜治疗胃黏膜下肿瘤61例临床分析[J]. 中国内镜杂志, 2016, 22(3):18-22.
[9] 王军, 樊丽琳, 沈小春, 等. 小探头超声内镜联合CT检查对较大胃黏膜下肿瘤治疗方案选择的价值[J]. 第三军医大学学报, 2012, 34(12):1135-1137.
[10] 张其德, 韩树堂. 经内镜侧缘切开隧道技术在治疗胃黏膜下肿瘤中的初步应用[J]. 中华消化内镜杂志, 2017, 34(4):281-283.
[11] Demetri GD, von Mehren M, Antonescu CR, et al. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors[J]. J Natl Compr Canc Netw, 2010, 8 Suppl 2(0 2): S1-S41; quiz S42-S44.
[12] 刘靖正, 胡健卫, 任重, 等. 体外牙线牵引辅助在内镜全层切除术治疗胃黏膜下肿瘤中的应用[J]. 中国内镜杂志, 2017, 23(9):94-98.
[13] 李歆, 肖勇, 吴楠楠, 等. 预荷包缝合技术在腔外生长型胃黏膜下肿瘤内镜治疗中的应用[J]. 中华消化内镜杂志, 2017, 34(8):586-589.
[14] 王珊珊, 沈磊. 单钳道内镜下荷包缝合法封闭贲门及胃底黏膜下肿瘤内镜下全层切除术后胃壁缺损的应用价值(含视频)[J]. 中华消化内镜杂志, 2017, 34(6):414-417.
[15] Catalano F, Rodella L, Lombardo F, et al. Endoscopic submucosal dissection in the treatment of gastic submucosal tumors: results from a retrospective cohort study[J]. Gastric Cancer, 2013, 16(4):563-570.
[16] Joensuu H, Hohenberger P, Corless CL. Gastrointestinal stromal tumour[J]. Lancet, 2013, 382(9896):973-983.
[17] Komuro T. Structure and organization of interstitial cells of Cajal in the gastrointestinal tract[J]. J Physiol, 2006, 576(Pt 3):653-658.
[18] 詹磊磊, 周红梅. 二氧化碳在内镜黏膜下剥离术中的应用[J]. 中华消化内镜杂志, 2015, 32(4):246-249.
文章导航

/