Li Xin, Wei Rongfen, Qin Jianfu, Qin Fei, Peng Peng, Qin Mengbin, Liu Shiquan, Huang Jiean
Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007 Guangxi Province, China.
Gastroenterol Res Pract. 2021 Mar 19;2021:4578191. doi: 10.1155/2021/4578191. eCollection 2021.
To evaluate the methodology, feasibility, safety, and efficacy of a novel method called over-the-scope clip- (OTSC-) associated endoscopic muscular dissection for small GSMT.
A pilot study on small GSMT diameter ≤ 1 cm was performed. OTSC-associated endoscopic muscular dissection was based on the requirement of OTSC apparatus and ESD technique; after ligaturing the bottom of small GSMT by OTSC, ESD was performed to resect the tumors, and the wounds of ESD were closed by clips finally. All the patients were followed up for more than 3 months, and the complications during and after OTSC-associated endoscopic muscular dissection were recorded.
A total of 7 consecutive patients with small GSMT were included. All tumors were completely dissected without any perforation or infection during and after the procedure in all cases, while three patients had mild abdominal pain, and one experienced postoperative bleeding after the procedure which was treated by the endoscopy with titanium clips. All the patients were followed by endoscopy three months later, all the wounds healed well, and all the OTSCs were still in the gastric wall.
OTSC-associated endoscopic muscular dissection as a novel endoscopic interventional therapy should be a convenient, safe, and effective therapy for small GSMT. The short-time outcome is excellent, whereas long-term effect is unclear, and the further follow-up is needed to schedule.
评估一种名为套扎器辅助内镜下肌层剥离术（OTSC-EMD）的新方法用于治疗小的胃黏膜下肿瘤（GSMT）的方法学、可行性、安全性及有效性。
对直径≤1cm的小GSMT进行一项前瞻性研究。OTSC-EMD基于OTSC设备及内镜黏膜下剥离术（ESD）技术的要求；通过OTSC对小GSMT底部进行套扎后，行ESD切除肿瘤，最后用夹子封闭ESD创面。所有患者随访超过3个月，并记录OTSC-EMD术中及术后的并发症。
共纳入7例连续性小GSMT患者。所有病例术中及术后所有肿瘤均被完整剥离，无穿孔或感染发生，3例患者出现轻度腹痛，1例术后发生出血，经内镜下钛夹治疗。所有患者于3个月后行内镜检查，所有创面愈合良好，所有OTSC仍位于胃壁内。
OTSC-EMD作为一种新型内镜介入治疗方法，对于小GSMT应是一种方便、安全且有效的治疗方法。短期效果良好，而长期效果尚不清楚，需要进一步随访观察。
