经黏膜下隧道内镜切除术治疗起源于固有肌层的上消化道黏膜下肿瘤。

Submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors originating from the muscularis propria layer.

作者信息

Wang Haiqin, Tan Yuyong, Zhou Yuqian, Wang Yongjun, Li Chenji, Zhou Junfeng, Duan Tianying, Zhang Jie, Liu Deliang

机构信息

Departments of aGeriatrics bGastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.

出版信息

Eur J Gastroenterol Hepatol. 2015 Jul;27(7):776-80. doi: 10.1097/MEG.0000000000000394.

DOI:10.1097/MEG.0000000000000394

PMID:25966671

Abstract

OBJECTIVE

To estimate the safety and efficacy of submucosal tunneling endoscopic resection (STER) for upper gastrointestinal submucosal tumors (SMTs) originating from the muscularis propria layer.

METHODS

During October 2011 and May 2014, a total of 80 patients with SMTs underwent STER at our hospital. A submucosal tunnel was created from 3-5 cm above the tumor. Endoscopic submucosal dissection of the SMT was performed, and then the mucosal incision was closed with several clips after the tumor was removed.

RESULTS

All the 80 patients underwent STER successfully, with a mean operation time of 61.2 min. Eighty-three SMTs were removed; among these, 67 were located in the esophagus and 16 in the gastric cardia, 68 were leiomyoma, and 15 were gastrointestinal stromal tumors, and 13 had a diameter no less than 35 mm. The mean tumor size was 23.2 mm; en-bloc resection was performed in 97.6% (81/83) of the tumors. Complications were noted in 8.75% (7/80) of the cases, and all of them resolved without the need for additional surgery. No recurrence was noted during a mean follow-up of 10.2 months.

CONCLUSION

STER appears to be a feasible, safe, and effective method for upper gastrointestinal SMTs originating from the muscularis propria layer, even when the size of the tumor was larger than 35 mm.

摘要

目的

评估黏膜下隧道内镜切除术（STER）治疗源于固有肌层的上消化道黏膜下肿瘤（SMTs）的安全性和有效性。

方法

2011年10月至2014年5月，我院共有80例SMTs患者接受了STER治疗。在肿瘤上方3 - 5 cm处建立黏膜下隧道。对SMT进行内镜下黏膜下剥离，肿瘤切除后用多个夹子关闭黏膜切口。

结果

80例患者均成功接受了STER治疗，平均手术时间为61.2分钟。共切除83个SMT；其中67个位于食管，16个位于贲门，68个为平滑肌瘤，15个为胃肠道间质瘤，13个直径不小于35 mm。肿瘤平均大小为23.2 mm；97.6%（81/83）的肿瘤实现了整块切除。8.75%（7/80）的病例出现并发症，所有并发症均无需额外手术即自行缓解。平均随访10.2个月期间未发现复发。