Department of Gastroenterology, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, Shenzhen, China.
Department of General Practice, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, Shenzhen, China.
Endoscopy. 2018 Dec;50(12):1180-1185. doi: 10.1055/a-0625-6326. Epub 2018 Jun 18.
This study aimed to evaluate the clinical efficacy, safety, and feasibility of performing endoscopic submucosal resection with a ligation device (ESMR-L) after apical mucosal incision (AMI) for the treatment of gastric subepithelial tumors originating from the muscularis propria (SET-MPs).
14 patients with gastric SET-MPs were treated by ESMR-L with AMI between December 2016 and May 2017. The complete resection rate, operation duration, and postoperative complications were collected. All patients were followed for 2 - 6 months.
The complete resection rate was 100 %, the mean tumor size was 10.71 ± 3.45 mm (7 - 18 mm), and the median operative time was 18.5 minutes. Perforation occurred in four patients, with all lesions being completely repaired endoscopically. No delayed bleeding or peritoneal signs were observed. No residual lesions or recurrence were found during the follow-up period.
AMI with ESMR-L appears to be an efficient and simple method for the histological diagnosis of gastric SET-MPs, but it carries a high perforation rate and cannot guarantee cure.
本研究旨在评估经顶端黏膜切开（AMI）后使用结扎装置行内镜黏膜下剥离术（ESMR-L）治疗源于固有肌层的胃黏膜下肿瘤（SET-MPs）的临床疗效、安全性和可行性。
2016 年 12 月至 2017 年 5 月，对 14 例胃 SET-MPs 患者行 ESMR-L 联合 AMI 治疗。收集完全切除率、手术时间和术后并发症。所有患者均随访 2-6 个月。
完全切除率为 100%，平均肿瘤大小为 10.71±3.45mm（7-18mm），中位手术时间为 18.5 分钟。有 4 例患者发生穿孔，所有病变均经内镜完全修复。未观察到迟发性出血或腹膜征象。随访期间无残留病变或复发。
AMI 联合 ESMR-L 似乎是一种有效且简单的胃 SET-MPs 组织学诊断方法，但穿孔率较高，不能保证治愈。
