Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA.
Can J Gastroenterol Hepatol. 2019 May 2;2019:1083053. doi: 10.1155/2019/1083053. eCollection 2019.
ESE (endoscopic submucosal excavation) is widely used for the treatment of digestive diseases. The dental floss traction (DFT) method has been successfully used to facilitate ESE to resect mucosal lesions such as early gastric cancer. DFT has not been used in ESE to remove submucosal masses. This study aimed to examine the efficacy of DFT-assisted ESE (DFT- ESE) for the removal of submucous masses.
From March 2017 to May 2017, a total of 12 patients with gastric submucosal masses at the First Affiliated Hospital of Nanchang University, Jiangxi, China, were enrolled. The tumor characteristics, en bloc resection rates, complications, and outcomes on follow-up were evaluated for all patients.
The 12 submucosal tumors were completely removed by DFT- ESE. Nine were gastrointestinal stromal tumors. Two were Schwannoma, located in the greater curvature of the gastric corpus. One was gastric ectopic pancreas. All the resected tumors were removed completely with intact tumor capsules. There was no more bleeding or perforation after the endoscopic closure of the perforation or the wound after the DFT-ESE, and no recurrences were identified at the time of follow-up.
The DFT method efficiently and safely facilitated the ESE procedure during the resection of gastric submucosal tumors. This study was registered with Chinese Clinical Trial Registry under Registration number ChiCTR-OOC-15005833).
内镜黏膜下挖除术(ESE)广泛用于治疗消化系统疾病。牙线牵引(DFT)法已成功用于促进 ESE 切除早期胃癌等黏膜病变。DFT 尚未用于 ESE 切除黏膜下肿块。本研究旨在探讨 DFT 辅助 ESE(DFT-ESE)切除黏膜下肿块的疗效。
2017 年 3 月至 2017 年 5 月,南昌大学第一附属医院共纳入 12 例胃黏膜下肿块患者。评估所有患者的肿瘤特征、整块切除率、并发症和随访结果。
12 个黏膜下肿瘤均通过 DFT-ESE 完全切除。其中 9 例为胃肠道间质瘤,2 例为位于胃体大弯的施万细胞瘤,1 例为胃异位胰腺。所有切除的肿瘤均完整切除,肿瘤包膜完整。DFT-ESE 后内镜穿孔或伤口闭合后无再出血或穿孔,随访时无复发。
DFT 方法可有效、安全地促进胃黏膜下肿瘤的 ESE 切除。本研究在中国临床试验注册中心注册,注册号 ChiCTR-OOC-15005833。