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内镜下切除胃底和贲门巨大不规则平滑肌瘤:一例报告。

Endoscopic resection of a giant irregular leiomyoma in fundus and cardia: A case report.

作者信息

Li Peng, Tang Guang-Ming, Li Pei-Lin, Zhang Chun, Wang Wei-Qiang

机构信息

Department of Gastroenterology, Central Hospital Affiliated to Chongqing University of Technology, Chongqing 400054, China.

Department of Hepatological Surgery, Central Hospital Affiliated to Chongqing University of Technology, Chongqing 400054, China.

出版信息

World J Gastrointest Endosc. 2024 Dec 16;16(12):678-685. doi: 10.4253/wjge.v16.i12.678.

Abstract

BACKGROUND

Endoscopic resection of giant gastric leiomyomas, particularly in the fundus and cardia regions, is infrequently documented and presents a significant challenge for endoscopic surgery.

CASE SUMMARY

Herein, a case of a 59-year-old woman with a giant gastric leiomyoma was reported. The patient presented to the department of hepatological surgery with a complaint of right upper abdominal pain for one month and worsening for one week. The patient was diagnosed as gastric submucosal tumor (SMT), gallstone, and cholecystitis combined with computed tomography and gastroendoscopy prior to operation. Upon admission, following a multi-disciplinary treatment discussion, it was determined that the patient would undergo a laparoscopic cholecystectomy and endoscopic resection of gastric SMT. It took 3 hours to completely resect the lesion by Endoscopic submucosal excavation and endoscopic full-thickness resection, and about 3 hours to suture the wound and take out the lesion. The lesion, ginger-shaped and measuring 8 cm × 5 cm, led to transient peritonitis post-surgery. With no cardiac complications, the patient was discharged one week after surgery.

CONCLUSION

Endoscopic resection of a giant leiomyoma in the cardiac fundus is feasible and suitable for skilled endoscopists.

摘要

背景

内镜下切除巨大胃平滑肌瘤,尤其是在胃底和贲门区域,相关文献报道较少,且给内镜手术带来重大挑战。

病例摘要

本文报道了一例59岁患有巨大胃平滑肌瘤的女性患者。该患者因右上腹疼痛1个月,加重1周就诊于肝脏外科。术前经计算机断层扫描和胃镜检查,患者被诊断为胃黏膜下肿瘤(SMT)、胆结石和胆囊炎。入院后,经多学科治疗讨论,决定患者接受腹腔镜胆囊切除术和胃SMT内镜切除术。通过内镜黏膜下挖除术和内镜全层切除术完全切除病变耗时3小时,缝合伤口并取出病变约耗时3小时。病变呈姜形,大小为8 cm×5 cm,术后导致短暂性腹膜炎。无心脏并发症,患者术后1周出院。

结论

内镜下切除贲门胃底巨大平滑肌瘤是可行的,适合技术熟练的内镜医师。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd5/11669962/10c51f9f55bb/WJGE-16-678-g001.jpg

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