超声内镜在上消化道间质瘤最佳内镜治疗中的选择。
EUS for choosing best endoscopic treatment of mesenchymal tumors of upper gastrointestinal tract.
机构信息
Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
出版信息
World J Gastroenterol. 2011 Apr 7;17(13):1766-71. doi: 10.3748/wjg.v17.i13.1766.
AIM
To evaluate the value of endoscopic ultrasonography (EUS) in the choice of endoscopic therapy strategies for mesenchymal tumors of the upper gastrointestinal tract.
METHODS
From July 2004 to September 2010, 1050 patients with upper gastrointestinal mesenchymal tumors (GIMTs) were diagnosed using EUS. Among them, 201 patients underwent different endoscopic therapies based on the deriving layers, growth patterns and lesion sizes.
RESULTS
Using EUS, we found 543 leiomyomas and 507 stromal tumors. One hundred and thirty-three leiomyomas and 24 stromal tumors were treated by snare electrosection, 6 leiomyomas and 20 stromal tumors were treated by endoloop, 10 stromal tumors were treated by endoscopic mucosal resection and 8 stromal tumors were treated by endoscopic submucosal dissection. Complete resection of the lesion was achieved in all cases. Of the mesenchymal tumors, 90.38% diagnosed by EUS were also identified by pathohistology. All wounds were closed up nicely and no recurrence was found in the follow-up after 2 mo.
CONCLUSION
EUS is an effective means of diagnosis for upper GIMTs and is an important tool in choosing the endoscopic therapy for GIMTs, by which the lesions can be treated safely and effectively.
目的
评估内镜超声（EUS）在上消化道间质瘤（GIMTs）内镜治疗策略选择中的价值。
方法
2004 年 7 月至 2010 年 9 月，1050 例上消化道间质瘤患者接受 EUS 诊断。其中，201 例患者根据起源层、生长模式和病变大小进行了不同的内镜治疗。
结果
使用 EUS，我们发现 543 例平滑肌瘤和 507 例间质瘤。133 例平滑肌瘤和 24 例间质瘤采用圈套电切治疗，6 例平滑肌瘤和 20 例间质瘤采用套扎环治疗，10 例间质瘤采用内镜黏膜切除术治疗，8 例间质瘤采用内镜黏膜下剥离术治疗。所有病例均达到病变完全切除。EUS 诊断的间质瘤中，90.38%经病理组织学证实。所有伤口均愈合良好，随访 2 个月后无复发。
结论
EUS 是诊断上消化道 GIMTs 的有效手段，也是选择 GIMTs 内镜治疗的重要工具，可安全有效地治疗病变。
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