Department of Gastroenterology, Zhongshan City People's Hospital, Zhongshan 528400, Guangdong Province, China.
Comput Math Methods Med. 2022 Sep 26;2022:4457696. doi: 10.1155/2022/4457696. eCollection 2022.
To analyze the efficacy and safety of submucosal tunnel endoscopic resection (STER) for the treatment of submucosal masses in esophageal muscularis propria.
A total of 272 patients with submucosal masses in esophageal muscularis propria diagnosed and treated in our hospital from February 2019 to January 2022 were randomly selected for the study and then were randomly divided into the STER group ( = 136) and the endoscopic mucosal dissection (ESD) group ( = 136) according to the random number table method. Patients in the STER and ESD groups were treated with STER and ESD, respectively. The clinical data of patients from the two groups were collected and compared. The clinical effects and the changes of surgery-related indexes of patients after ESD and STER treatment were observed. The safety of ESD and STER was compared. The factors influencing the efficacy of STER treatment for submucosal masses in esophageal muscularis propria were analyzed.
There were significant differences between the STER group and the ESD group in terms of tumor size, lesion level, adhesion and surgical approaches ( < 0.05). The effective rates of ESD treatment and STER treatment were 98.53% and 88.97%, respectively. Meanwhile, the effective rates of STER treatment were significantly higher than those in the control group ( < 0.05). In addition, the patients in the STER group had longer operation time, less blood loss, and shorter hospital stay compared with those in the ESD group ( < 0.05). Adverse reactions occurred during ESD treatment and STER treatment included delayed bleeding, adhesion, perforation, and pleural effusion with the total incidence of adverse reactions of 4.41% and 13.97%, respectively. The adverse reactions in STER group were prominently less than these in the ESD group ( < 0.05). Logistic multivariate regression analysis showed that independent risk factors, including tumor size, lesion level, adhesion, and surgical approaches, affected the efficacy of STER in the treatment of submucosal masses in esophageal muscularis propria ( < 0.05).
STER is an effective method for the treatment of submucosal masses in esophageal muscularis propria, which can exhibit a good effect with faster postoperative recovery and higher safety, thereby being worthy of clinical application and promotion. Tumor size, lesion level, adhesion, and surgical approaches are all related factors affecting the effect of STER treatment.
分析黏膜下隧道内镜切除术（STER）治疗食管固有肌层黏膜下肿块的疗效和安全性。
选取 2019 年 2 月至 2022 年 1 月我院收治的 272 例食管固有肌层黏膜下肿块患者为研究对象，采用随机数表法将其分为 STER 组（n=136）和内镜黏膜下剥离术（ESD）组（n=136）。STER 组和 ESD 组患者分别采用 STER 术和 ESD 术治疗。收集两组患者的临床资料并进行比较，观察患者 ESD 术和 STER 术后的临床效果及手术相关指标的变化，比较 ESD 术和 STER 术的安全性，分析影响 STER 术治疗食管固有肌层黏膜下肿块疗效的因素。
STER 组和 ESD 组患者的肿瘤大小、病变部位、黏连情况及手术方式比较，差异均有统计学意义（<0.05）。ESD 术和 STER 术的治疗有效率分别为 98.53%和 88.97%，STER 术的治疗有效率显著高于 ESD 术（<0.05）。此外，STER 组患者的手术时间长于 ESD 组，术中出血量少于 ESD 组，住院时间短于 ESD 组（<0.05）。ESD 术和 STER 术治疗后均出现延迟出血、黏连、穿孔、胸腔积液等不良反应，不良反应总发生率分别为 4.41%和 13.97%，STER 组的不良反应发生率明显低于 ESD 组（<0.05）。Logistic 多因素回归分析显示，肿瘤大小、病变部位、黏连情况及手术方式是影响 STER 术治疗食管固有肌层黏膜下肿块疗效的独立危险因素（<0.05）。
STER 治疗食管固有肌层黏膜下肿块的效果显著，术后恢复较快，安全性较高，值得临床应用和推广。肿瘤大小、病变部位、黏连情况及手术方式均是影响 STER 术治疗效果的相关因素。
