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黏膜下单隧道内镜切除术治疗起源于固有肌层的上消化道多发性黏膜下肿瘤:附12例报告

Submucosal 1-tunnel endoscopic resection for treating upper gastrointestinal multiple submucosal tumor originating from the muscularis propria layer: A report of 12 cases.

作者信息

Wang Haiqin, Tan Yuyong, Huo Jirong, Liu Deliang

机构信息

Department of Geriatrics.

Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

Medicine (Baltimore). 2019 Feb;98(6):e14484. doi: 10.1097/MD.0000000000014484.

Abstract

To explore the feasibility and efficacy of submucosal 1-tunnel endoscopic resection (1-tunnel STER) for the treatment of multiple upper gastrointestinal submucosal tumors (GI-SMTs) originating from the muscularis propria (MP) layer.A total of 12 patients with multiple upper GI-SMTs (no less than 2 SMTs) who underwent 1-tunnel STER from April 2013 to October 2017 were included. Clinical data on general characteristics, operation-related parameters, adverse events, and follow-up results were recorded and analyzed.All 12 patients underwent 1-tunnel STER successfully, and the mean operation time was 92.1 ± 40.8 minutes. A total of 30 SMTs were resected, out of which 27 were in the esophagus and 3 were in the stomach. The mean diameter was 15.0 ± 8.2 mm (range, 3-38 mm). All the SMTs were resected en bloc uneventfully. The SMTs comprised 28 leiomyomas and 2 gastric stromal tumors (low risk). No recurrence was noticed during a mean follow-up of 24.9 ± 15.3 months (range, 1-52 months).One-tunnel STER may serve as a feasible and effective technique for the treatment of multiple upper GI-SMTs originating from the MP layer. A large-scale prospective study is warranted for a confirmative conclusion.

摘要

探讨黏膜下单隧道内镜切除术(1-tunnel STER)治疗起源于固有肌层(MP)的多发上消化道黏膜下肿瘤(GI-SMTs)的可行性和疗效。纳入2013年4月至2017年10月期间接受1-tunnel STER治疗的12例多发上消化道GI-SMTs(不少于2个SMTs)患者。记录并分析患者的一般特征、手术相关参数、不良事件及随访结果等临床资料。12例患者均成功接受1-tunnel STER治疗,平均手术时间为92.1±40.8分钟。共切除30个SMTs,其中27个位于食管,3个位于胃。平均直径为15.0±8.2mm(范围3-38mm)。所有SMTs均完整切除,过程顺利。SMTs包括28个平滑肌瘤和2个胃间质瘤(低风险)。平均随访24.9±15.3个月(范围1-52个月),未发现复发。单隧道STER可作为治疗起源于MP层的多发上消化道GI-SMTs的一种可行且有效的技术。需要进行大规模前瞻性研究以得出肯定结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/086c/6380810/7a5a01d6821b/medi-98-e14484-g001.jpg

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