Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Wenzhou Medical College, Linhai, Zhejiang Province, China.
Dig Liver Dis. 2013 Feb;45(2):119-23. doi: 10.1016/j.dld.2012.08.010. Epub 2012 Sep 16.
The aim of this prospective study was to evaluate the feasibility of submucosal tunnelling endoscopic resection of esophageal tumours originating from the muscularis propria layer.
Fifteen patients with esophageal submucosal tumours originating from the muscularis propria layer underwent submucosal tunnelling endoscopic resection between August 2011 and February 2012. The key steps were: (1) creating a submucosal tunnel from 5 cm above the tumour between the submucosal and muscular layers with a hook knife or hybrid knife; (2) dissecting the tumour by the technique of endoscopic submucosal dissection; (3) closing the mucosal incision site with clips after the tumour was removed.
Submucosal tunnelling endoscopic resection was successfully performed in all cases. The en bloc resection rate was 100%. The average tumour diameter was 1.8 cm (range 1.0-3.0 cm). During the procedure, perforation occurred in 3 patients, who recovered after conservative treatment. No residual tumour or tumour recurrence was detected during the follow-up period (mean: 3.5 months, range: 1-9 months). Pathological diagnoses of these tumours were leiomyomas (12/15) and gastrointestinal stromal tumours (3/15).
Submucosal tunnelling endoscopic resection is a feasible method for the treatment of small esophageal submucosal tumours originating from the muscularis propria layer.
本前瞻性研究旨在评估经黏膜下隧道内镜切除术治疗起源于固有肌层的食管肿瘤的可行性。
2011 年 8 月至 2012 年 2 月，15 例起源于固有肌层的食管黏膜下肿瘤患者接受了经黏膜下隧道内镜切除术。关键步骤包括：（1）在黏膜下和固有肌层之间，用钩刀或混合刀从肿瘤上方 5cm 处开始建立黏膜下隧道；（2）通过内镜黏膜下剥离术技术剥离肿瘤；（3）在肿瘤切除后用夹闭器闭合黏膜切口。
所有患者均成功完成经黏膜下隧道内镜切除术。整块切除率为 100%。平均肿瘤直径为 1.8cm（范围 1.0-3.0cm）。术中 3 例发生穿孔，经保守治疗后恢复。随访期间（平均 3.5 个月，范围 1-9 个月）未发现肿瘤残留或复发。这些肿瘤的病理诊断为平滑肌瘤（12/15）和胃肠道间质瘤（3/15）。
经黏膜下隧道内镜切除术是治疗起源于固有肌层的小食管黏膜下肿瘤的一种可行方法。
