摘要
目的探讨内镜微创治疗胃黏膜下肿瘤的安全性及有效性。方法回顾性分析2014年2月至2019年2月行内镜微创手术的152例胃黏膜下肿瘤患者的临床资料,瘤体平均直径(1.32±0.80)cm。行内镜黏膜下剥离术(ESD)139例,内镜全层切除术(EFR)13例。结果整块切除率100%。创面关闭良好,均无严重并发症。ESD组30例起源于黏膜肌层,57例起源于黏膜下层,52例起源于固有肌浅层,切除瘤体最大直径4.5 cm;EFR组13例均起源于固有肌深层,且与浆膜层粘连,切除瘤体最大直径2.2 cm。ESD组和EFR组手术时间[(46.43±17.32)min vs(48.92±20.50)min]、术后进流食时间[(2.12±1.13)d vs(2.50±1.52)d]、术后住院时间[(5.41±2.22)d vs(5.73±1.99)d],比较无统计学差异(P均>0.05)。出院后随访6~38个月,平均随访20个月,未见残留及复发病例。结论内镜微创切除胃黏膜下肿瘤是安全、有效的治疗方法,EFR为治疗胃黏膜下肿瘤可提供更广阔的前景。
Objective To explore the safety and effectiveness of endoscopic minimally invasive treatment of gastric submucosal tumor.Methods The clinical data of 152 patients with gastric submucosal tumor undergoing endoscopic minimally invasive surgery from February 2014 to February 2019 were analyzed retrospectively.The average diameter of tumor was(1.32±0.80)cm.Endoscopic submucosal dissection(ESD group)was performed in 139 cases,and endoscopic full-thickness resection(EFR group)was conducted in 13 cases.Results The total resection rate was 100%.The wound healed well without serious complications.In ESD group,there were 30 cases originated from the muscularis mucosa,57 cases from the submucosa,52 cases from the superficial layer of the intrinsic muscle,and the maximum tumor diameter was 4.5 cm.In EFR group,13 cases were all originated from the deep layer of intrinsic muscle and adhered to the serous layer,and the largest tumor diameter was 2.2 cm.There were no significant differences in the operation time[(46.43±17.32)min vs(48.92±20.50)min],postoperative fluid feeding time[(2.12±1.13)d vs(2.50±1.52)d],postoperative hospital stay[(5.41±2.22)d vs(5.73±1.99)d]between ESD group and EFR group(all P>0.05).After discharge,the mean follow-up was 20 months(range from 6-38 months).No residual or recurrent cases were found.Conclusion In the treatment of gastric submucosal tumors,endoscopic minimally invasive resection is safe and effective,however,endoscopic full-thickness resection provides a broader prospect for patients.
作者
崔月
李胜昔
姚远
徐美东
CUI Yue;LI Sheng-xi;YAO Yuan;XU Mei-dong(Digestive Endoscopy Center,the People's Hospital of China Medical University,the People's Hospital of Liaoning Province,Shenyang,Liaoning 110016,China;不详)
出处
《中国临床研究》
CAS
2020年第7期890-893,共4页
Chinese Journal of Clinical Research
基金
辽宁省自然科学基金重点项目(20170540525)
辽宁省自然科学基金项目(201602432)。
关键词
胃黏膜下肿瘤
内镜治疗
回顾性研究
内镜黏膜下剥离术
内镜全层切除术
Gastric submucosal tumor
Endoscopic treatment
Retrospective study
Endoscopic submucosal dissection
Endoscopic full-thickness resection
