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内镜超声及内镜切除术治疗食管神经鞘瘤的疗效

Efficacy of endoscopic ultrasound and endoscopic resection for esophageal schwannoma.

作者信息

Jiao Jiao, Fan Xiaofei, Luo Lili, Zhao Wei, Zheng Zhongqing, Chen Xin, Wang Tao, Wang Bangmao, Liu Wentian

机构信息

Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.

Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China.

出版信息

Scand J Gastroenterol. 2023 Jul-Dec;58(8):963-969. doi: 10.1080/00365521.2023.2185867. Epub 2023 Mar 7.

Abstract

BACKGROUND

Esophageal schwannoma (ES) is a rare submucosal tumor, and its complete and safe resection is a topic that deserves special attention.

AIM

This study aimed to investigate the clinical value of endoscopic ultrasound (EUS) in the diagnosis of ES and the clinical efficacy of endoscopic resection for ES.

METHODS

The clinical data, endoscopic characteristics, endoscopic treatment, postoperative complications, immunohistochemical results, and follow-up records of patients with ES admitted to the Tianjin Medical University General Hospital from January 2012 to January 2022 were retrospectively analyzed.

RESULTS

Under white-light endoscopy, 81.8% (9/11) of lesions were submucosal elevations, covering the normal esophageal epithelium. Two of the lesions with redness and erosive surface. Eight lesions (72.7%) appear on EUS originating from the muscularis propria were homogeneous or inhomogeneous hypoechoic signals. Two lesions were inhomogeneous hyperechoic originating from the submucosa or muscularis propria, respectively. One lesion was homogeneous hypoechoic originating from the submucosa. All lesions had no blood flow signals, cystic changes, or calcification, and were completely removed by submucosal tunnel endoscopic resection (STER) or endoscopic submucosal dissection (ESD). All patients did not experience serious adverse events as well as recurrence, metastasis, or cicatricial esophageal stenosis during the follow-up period.

CONCLUSION

ES is a rare submucosal lesion, which endoscopic characteristics are difficult to distinguish from other esophageal submucosal tumors. Endoscopic resection can provide a minimally invasive and alternative treatment for ES.

摘要

背景

食管神经鞘瘤(ES)是一种罕见的黏膜下肿瘤,其完整且安全的切除是一个值得特别关注的话题。

目的

本研究旨在探讨内镜超声(EUS)在ES诊断中的临床价值以及内镜切除治疗ES的临床疗效。

方法

回顾性分析2012年1月至2022年1月在天津医科大学总医院收治的ES患者的临床资料、内镜特征、内镜治疗、术后并发症、免疫组化结果及随访记录。

结果

在白光内镜下,81.8%(9/11)的病变为黏膜下隆起,覆盖正常食管上皮。其中2处病变表面发红且有糜烂。8处病变(72.7%)在EUS上表现为起源于固有肌层的均匀或不均匀低回声信号。2处病变分别起源于黏膜下层或固有肌层,表现为不均匀高回声。1处病变起源于黏膜下层,为均匀低回声。所有病变均无血流信号、囊性改变或钙化,均通过黏膜下隧道内镜切除术(STER)或内镜黏膜下剥离术(ESD)完整切除。所有患者在随访期间均未发生严重不良事件以及复发、转移或瘢痕性食管狭窄。

结论

ES是一种罕见的黏膜下病变,其内镜特征难以与其他食管黏膜下肿瘤相鉴别。内镜切除可为ES提供一种微创且可选择的治疗方法。

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