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浆膜翻转辅助内镜下食管胃交界部外来巨大肿物全层黏膜切除术

Serosal overturning assisted endoscopic full-thickness mucosal resection of extraneous giant mass at the esophagogastric junction.

作者信息

Qin Shumin, Lin Xiaofeng, Wen Shuting, Liu Tianwen

机构信息

Department of Gastroenterology The Second Affiliated Hospital of Guanzhou University of Chinese Medicine Guangzhou China.

出版信息

Clin Case Rep. 2024 Aug 6;12(8):e9226. doi: 10.1002/ccr3.9226. eCollection 2024 Aug.

Abstract

KEY CLINICAL MESSAGE

Serosal overturning assisted endoscopic full-thickness mucosal resection was performed on the extraneous giant masses at the esophagogastric junction without complications.

ABSTRACT

It is difficult to perform endoscopic resection of masses at the gastroesophageal junction (GEJ). In particular, the extraneous giant masses surrounding the extraneous giant masses is infrequent. As one of the technologies of endoscopic resection, endoscopic full-thickness resection (EFTR) is generally applicable to the submucosal tumor of stomach, duodenum and colorectal that originate from the musculus propria and protrude to subserous or partial growth outside the luminal layer. Successful endoscopic repair of perforation is crucial in avoiding the need for surgical repair and preventing postoperative peritonitis, making it a key aspect of EFTR treatment. We report a 56-year-old woman who was admitted to our department complaining of 5-year history of masses of esophagogastric junction and 2-month history of feeling of gastric distension. Gastroscopy showed a 4 cm submucosal mass near the fundus of the stomach from the cardia. Computed tomography scan revealed submucosal lesions in esophagogastric junction, which was exogenous. We successfully performed Serosal overturning assisted endoscopic full-thickness mucosal resection on the extraneous giant masses at the esophagogastric junction without complications. The clinical symptoms were significantly improved within postoperative 1 month. There was no recurrence 8 months after the operation. Serosal overturning assisted EFTR is possibly an effective and minimally invasive method of extraneous giant masses at the esophagogastric junction.

摘要

关键临床信息

对食管胃交界处的外部巨大肿块进行了浆膜翻转辅助内镜全层黏膜切除术,无并发症发生。

摘要

食管胃交界处(GEJ)肿块的内镜切除具有挑战性。特别是,围绕外部巨大肿块的外部巨大肿块很少见。作为内镜切除技术之一,内镜全层切除术(EFTR)一般适用于起源于固有肌层并向浆膜下突出或在腔层外部分生长的胃、十二指肠和结肠的黏膜下肿瘤。成功的内镜下穿孔修复对于避免手术修复和预防术后腹膜炎至关重要,这是EFTR治疗的关键方面。我们报告了一名56岁女性,因食管胃交界处肿块5年病史及胃胀感2个月入院。胃镜检查显示距贲门胃底附近有一个4厘米的黏膜下肿块。计算机断层扫描显示食管胃交界处有黏膜下病变,为外生性。我们成功地对食管胃交界处的外部巨大肿块进行了浆膜翻转辅助内镜全层黏膜切除术,无并发症发生。术后1个月内临床症状明显改善。术后8个月无复发。浆膜翻转辅助EFTR可能是治疗食管胃交界处外部巨大肿块的一种有效且微创的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a73/11301275/1e5f11f977a9/CCR3-12-e9226-g003.jpg

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