Liu Lu, Guo Hai-Mei, Miao Feng, Li Nuo, Jiao Shu-Hua, Cai Shuang, Liu Peng-Liang, Zhang Shan-Shan, Ma Jia, Weng Yang, Sun Ying, Tang Yin-Si, Zhao Feng, Zheng Yan, Zhang Shen, Yang Yan, Zhao Zhi-Feng
Department of Gastroenterology, The Fourth Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning Province, China.
J Oncol. 2020 Aug 20;2020:5259717. doi: 10.1155/2020/5259717. eCollection 2020.
To analyze the types and properties of cystic lesions originating from the muscularis propria of the gastric cardia (CLMPGC), explore the growth pattern and anatomical characteristics, and evaluate the safety, feasibility, and clinical efficacy of endoscopic esophageal submucosal tunnel dissection (ESTD).
From September 2013 to July 2018, we treated 6 patients with CLMPGC whom we had diagnosed using endoscopy, endoscopic ultrasound (EUS), and Computed Tomography (CT) before the operations. ESTD was the best option for treatment for all these patients. Postoperative observation and follow-ups were performed, and the operational, clinical data, and treatment results are analyzed.
The mean age of the patients was 50.67 ± 11.59 years (male : female = 1 : 1). The only clinical manifestations the patients exhibited were upper abdominal discomfort. The diameter of the masses was 2.05 ± 0.73 (1.1-3.0) cm. The duration of the ESTD operation was 93.5 (82-256) mins, and the length of hospital stay was 7.50 ± 1.38 days. Postoperative pathology showed 4 cases of an epithelioid cyst, and 2 cases of mucocele with xanthogranuloma. There were no complications, such as hemorrhage, pneumothorax, and pleural effusion during and after the operation. No recurrence during the follow-ups was observed.
The CLMPGC were mainly mucocele and epidermoid cyst, in an expansive growth pattern, and these lesions had no distinct borders with the muscularis propria. The muscularis propria formed a complete wall of the lesion. There was no direct blood supply to the lesions from big blood vessels. Endoscopic esophageal submucosal tunnel dissection was a safe, feasible, and effective treatment for CLMPGC.
分析贲门固有肌层囊性病变（CLMPGC）的类型及性质，探讨其生长方式及解剖特点，评估内镜下食管黏膜下隧道剥离术（ESTD）治疗的安全性、可行性及临床疗效。
2013年9月至2018年7月，我们对6例CLMPGC患者进行了治疗，术前均经内镜、超声内镜（EUS）及计算机断层扫描（CT）确诊。ESTD是所有这些患者的最佳治疗选择。术后进行观察及随访，并分析手术、临床资料及治疗结果。
患者平均年龄50.67±11.59岁（男∶女 = 1∶1）。患者仅表现为上腹部不适。肿块直径为2.05±0.73（1.1 - 3.0）cm。ESTD手术时间为93.5（82 - 256）分钟，住院时间为7.50±1.38天。术后病理显示4例上皮样囊肿，2例黏液囊肿伴黄色肉芽肿。手术中及术后均未出现出血、气胸及胸腔积液等并发症。随访期间未观察到复发。
CLMPGC主要为黏液囊肿和表皮样囊肿，呈膨胀性生长方式，与固有肌层无明显边界，固有肌层构成病变完整壁。病变无大血管直接供血。内镜下食管黏膜下隧道剥离术是治疗CLMPGC安全、可行且有效的方法。
