Zhang Jin-Shun, Ye Li-Ping, Wang Cai-Ya, Lin Min-Hua
Department of Gastroenterology, Taizhou Hospital, Zhejiang Province, China.
Hepatogastroenterology. 2012 Mar-Apr;59(114):440-3. doi: 10.5754/hge11783.
BACKGROUND/AIMS: Gastric gastrointestinal stromal tumors (gastric GISTs) are the most common gastric submucosal tumors with potential for malignant transformation. Our aim was to assess the efficacy and safety of ESE for gastric GISTs.
Small gastric GISTs were dealt with ESE between May 2007 and October 2010.
A total of 69 patients (42 men, 27 women; mean age 47.28±10.10 years) were treated. The mean diameter of the specimens was 1.87±0.57cm (range 0.7-3.0cm). The rates of intra-operative bleeding, delayed bleeding, perforation and surgery related complications were 7.25% (5/69), 1.45% (1/69), 33.33% (23/69) and 5.80% (4/69), respectively. The rate of perforation was 43.2% (19/44) at the fundus of the stomach and 16% (4/25) at the body (p=0.02). The mean time of the procedure was 41.07±10.79 minutes. Nineteen patients with perforation were treated by titanium clips and the rest by laparoscopy. Immunohistochemistry revealed that the positive rates of CD117 and CD34 were 88.41% and 68.12%, respectively. The gastric GISTs were all at low risk. At a mean follow-up period of 17.97±10.75 months (range 1 to 40 months) all of the patients were disease free.
ESE with a cross-shaped incision is possibly a very good choice for small gastric GISTs.
背景/目的：胃胃肠道间质瘤（胃GISTs）是最常见的胃黏膜下肿瘤，具有恶性转化的潜能。我们的目的是评估内镜粘膜下剥离术（ESE）治疗胃GISTs的疗效和安全性。
2007年5月至2010年10月期间，采用ESE治疗小胃GISTs。
共治疗69例患者（男42例，女27例；平均年龄47.28±10.10岁）。标本平均直径为1.87±0.57cm（范围0.7 - 3.0cm）。术中出血、延迟出血、穿孔及手术相关并发症的发生率分别为7.25%（5/69）、1.45%（1/69）、33.33%（23/69）和5.80%（4/69）。胃底部穿孔率为43.2%（19/44），胃体部为16%（4/25）（p = 0.02）。手术平均时间为41.07±10.79分钟。19例穿孔患者采用钛夹治疗，其余患者采用腹腔镜治疗。免疫组织化学显示，CD117和CD34的阳性率分别为88.41%和68.12%。胃GISTs均为低风险。平均随访期为17.97±10.75个月（范围1至40个月），所有患者均无疾病复发。
采用十字形切口的ESE可能是治疗小胃GISTs的一个很好的选择。
