对比分析来源于固有肌层的小型胃黏膜下肿瘤的两种不同内镜切除方法。

Comparison analysis of two different types of endoscopic resection procedures in small gastric subepithelial tumours originating frommuscularis propria.

机构信息

The Department of Gastroenterology, First Affiliated Hospital of Soochow University, Suzhou, China.

The Department of Gastroenterology, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.

出版信息

Scand J Gastroenterol. 2024 Jan-Jun;59(2):213-217. doi: 10.1080/00365521.2023.2257826. Epub 2023 Sep 12.

DOI:10.1080/00365521.2023.2257826

PMID:37698190

Abstract

BACKGROUND

For small gastric subepithelial tumours originating from the muscularis propria, there is no uniform standard for selecting the best endoscopic resection method.

OBJECTIVE

To compare the efficacy and safety of endoscopic snare resection with a transparent cap (ESR-C) and endoscopic snare resection with an elastic band (ESR-EB) for small gastric subepithelial tumours originating from the muscularis propria to determine which method is more suitable for these tumours.

METHODS

The data from small gastric subepithelial tumours originating from the muscularis propria treated from Jan 2020 to Dec 2022 were collected. A total of 34 eligible patients were enrolled. Sixteen of these patients were treated with ESR-C, and eighteen were treated with ESR-EB. The general clinical characteristics, tumour location, tumour size,growth pattern,operation time, complete resection rate, and complication rate were compared between the two groups.

RESULTS

There was no difference in age, sex, tumour location, tumour size, growth pattern, or histological diagnosis after resection ( > 0.05). There was no significant difference in operation time, complete resection rate, or follow-up time ( > 0.05). Eight patients (50.5%) in the ESR-C group had complications (6 perforations and 2 bleeding), and 2 (11.11%) in the ESR-EB group had complications (2 perforations). There were significant differences between the two groups ( = 0.037). All perforations were successfully treated. No recurrence or metastasis was observed in either group during the follow-up period.

CONCLUSION

Both ESR-C and ESR-EB are effective and safe in treating small gastric subepithelial tumours originating from the muscularis propria. However, ESR-EB can significantly reduce the incidence of complications. ESR-EB is likely a better option for small gastric subepithelial tumours originating from the muscularis propria.

摘要

背景

对于起源于固有肌层的小胃黏膜下肿瘤，目前尚没有统一的内镜切除方法选择标准。

目的

比较内镜圈套切除联合透明帽（ESR-C）与内镜圈套切除联合弹性橡皮圈（ESR-EB）治疗起源于固有肌层的小胃黏膜下肿瘤的疗效及安全性，以确定哪种方法更适合治疗此类肿瘤。

方法

收集 2020 年 1 月至 2022 年 12 月期间收治的起源于固有肌层的小胃黏膜下肿瘤患者的临床资料，共纳入 34 例患者，其中 16 例行 ESR-C 治疗，18 例行 ESR-EB 治疗。比较两组患者的一般临床特征、肿瘤部位、肿瘤大小、生长方式、手术时间、完整切除率及并发症发生率。

结果

两组患者的年龄、性别、肿瘤部位、肿瘤大小、生长方式及术后病理诊断比较，差异均无统计学意义（ > 0.05）。两组患者的手术时间、完整切除率及随访时间比较，差异均无统计学意义（ > 0.05）。ESR-C 组 8 例（50.5%）患者发生并发症（6 例穿孔，2 例出血），ESR-EB 组 2 例（11.11%）患者发生并发症（2 例穿孔），两组并发症发生率比较，差异有统计学意义（ = 0.037）。所有穿孔均经保守治疗成功治愈。两组患者均未出现复发或转移。