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[食管良性黏膜下肿瘤(平滑肌瘤和血管瘤)的手术治疗]

[Surgery for benign submucosal tumors of the esophagus (leiomyoma and hemangioma)].

作者信息

Kajiyama Yoshiaki, Iwanuma Yoshimi, Tomita Natsumi, Amano Takayuki, Uchida Yosuke, Kudo Keizo, Ando Takao, Tsurumaru Masahiko

机构信息

Department of Surgery, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 2003 Sep;104(9):593-6.

Abstract

Among the submucosal tumors of the esophagus, leiomyoma is the most frequently found. Esophageal leiomyoma usually originates from the muscle layer of the esophageal wall and grows spirally around the esophageal axis. In the surgical treatment of leiomyoma, we enucleate the tumor through video-assisted thoracic surgery. When we enucleate leiomyoma, we must be very careful to aviod perforation of the esophageal mucosa. Esophageal hemangioma is a relatively rare disease. The location of this disease is mainly within the submucosal layer, without invading the muscle layer proper. After confirming the localization within the mucosa or submucosa with endoscopic ultrasonography, esophageal hemangioma can be resected safely using the endoscopic mucosal resection technique. In the treatment of benign esophageal submucosal tumors, "informed consent" is as essential as in esophageal cancer surgery. We have no absolute criteria concerning the indications for surgery for benign esophageal submucosal tumors. We must give reasons why the operation is necessary and indicated to the patients. Surgical treatment of esophageal submucosal tumors should be as minimally invasive as possible.

摘要

在食管黏膜下肿瘤中,平滑肌瘤最为常见。食管平滑肌瘤通常起源于食管壁的肌层,并围绕食管轴呈螺旋状生长。在平滑肌瘤的外科治疗中,我们通过电视胸腔镜手术摘除肿瘤。当摘除平滑肌瘤时,我们必须非常小心,避免食管黏膜穿孔。食管血管瘤是一种相对罕见的疾病。该病的位置主要在黏膜下层,未侵犯固有肌层。在内镜超声确定其位于黏膜或黏膜下层后,可使用内镜黏膜切除术安全地切除食管血管瘤。在良性食管黏膜下肿瘤的治疗中,“知情同意”与食管癌手术一样至关重要。我们对于良性食管黏膜下肿瘤的手术指征没有绝对标准。我们必须向患者说明手术必要且可行的原因。食管黏膜下肿瘤的外科治疗应尽可能微创。

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