中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2012年
1期
59-62
,共4页
时强%钟芸诗%姚礼庆%周平红%徐美东%马丽黎
時彊%鐘蕓詩%姚禮慶%週平紅%徐美東%馬麗黎
시강%종예시%요례경%주평홍%서미동%마려려
Brunner腺瘤,十二指肠%内镜治疗%内镜黏膜切除术%内镜黏膜下剥离术
Brunner腺瘤,十二指腸%內鏡治療%內鏡黏膜切除術%內鏡黏膜下剝離術
Brunner선류,십이지장%내경치료%내경점막절제술%내경점막하박리술
Brunner adenoma,duodenal%Endoscopic treatment%Endoscopic mucosal resection%Endoscopic submucosal dissection
目的 探讨十二指肠Brunner腺瘤内镜治疗的价值.方法 回顾性分析2006年11月至2011年5月间复旦大学附属中山医院内镜中心行内镜治疗且经病理证实的29例十二指肠Brunner腺瘤患者的临床资料.结果 29例患者中男性13例,女性16例,中位年龄为55(29～72)岁.病灶大小( 1.7±0.1) cm,其中0.5～1.0 cm 17例,1.0～2.0 cm 6例,大于2.0 cm 6例.无蒂隆起性病灶18例；有蒂病灶11例,其中粗蒂3例,亚蒂2例.内镜治疗中采取圈套电切9例(其中3例外加尼龙绳结扎),内镜黏膜切除术12例,内镜黏膜下剥离术8例,均获完整切除.术中出血1例约200 ml,经多枚金属夹夹闭和尼龙绳圈套后成功止血；术中穿孔1例,予金属夹夹闭；术后第2天发生迟发性出血1例,行内镜止血.全组术后随访2～39(中位数13)个月,生活质量较好,未见任何远期并发症.术后1年复发1例,再次予内镜黏膜下剥离术治疗.结论 内镜治疗对于Brunner腺瘤是一种安全、有效的治疗方法.
目的 探討十二指腸Brunner腺瘤內鏡治療的價值.方法 迴顧性分析2006年11月至2011年5月間複旦大學附屬中山醫院內鏡中心行內鏡治療且經病理證實的29例十二指腸Brunner腺瘤患者的臨床資料.結果 29例患者中男性13例,女性16例,中位年齡為55(29～72)歲.病竈大小( 1.7±0.1) cm,其中0.5～1.0 cm 17例,1.0～2.0 cm 6例,大于2.0 cm 6例.無蒂隆起性病竈18例；有蒂病竈11例,其中粗蒂3例,亞蒂2例.內鏡治療中採取圈套電切9例(其中3例外加尼龍繩結扎),內鏡黏膜切除術12例,內鏡黏膜下剝離術8例,均穫完整切除.術中齣血1例約200 ml,經多枚金屬夾夾閉和尼龍繩圈套後成功止血；術中穿孔1例,予金屬夾夾閉；術後第2天髮生遲髮性齣血1例,行內鏡止血.全組術後隨訪2～39(中位數13)箇月,生活質量較好,未見任何遠期併髮癥.術後1年複髮1例,再次予內鏡黏膜下剝離術治療.結論 內鏡治療對于Brunner腺瘤是一種安全、有效的治療方法.
목적 탐토십이지장Brunner선류내경치료적개치.방법 회고성분석2006년11월지2011년5월간복단대학부속중산의원내경중심행내경치료차경병리증실적29례십이지장Brunner선류환자적림상자료.결과 29례환자중남성13례,녀성16례,중위년령위55(29～72)세.병조대소( 1.7±0.1) cm,기중0.5～1.0 cm 17례,1.0～2.0 cm 6례,대우2.0 cm 6례.무체륭기성병조18례；유체병조11례,기중조체3례,아체2례.내경치료중채취권투전절9례(기중3예외가니룡승결찰),내경점막절제술12례,내경점막하박리술8례,균획완정절제.술중출혈1례약200 ml,경다매금속협협폐화니룡승권투후성공지혈；술중천공1례,여금속협협폐；술후제2천발생지발성출혈1례,행내경지혈.전조술후수방2～39(중위수13)개월,생활질량교호,미견임하원기병발증.술후1년복발1례,재차여내경점막하박리술치료.결론 내경치료대우Brunner선류시일충안전、유효적치료방법.
Objective To evaluate the value of endoscopic treatment for duodenal Brunner adenoma.Methods Twenty-nine cases of duodenal Brunner adenoma were diagnosed by pathology between November 2006 and May 2010 in the Endoscopy Center of Zhongshan Hospital.The clinical data were retrospectively analyzed.Results In 29 cases,there were 13 males and 16 females.The median age was 55 (29-72) years.The mean adenoma diameter was (1.7±0.1) cm,among which 17 adenomas ranged from 0.5 to 1.0 cm,6 ranged from 1.0 to 2.0 cm,and 6 greater than 2.0 cm.Nine cases were treated by polypectomy,12 by endoscopic mucosal resection (EMR),and 8 by endoscopic submucosal dissection (ESD).En-bloc resection rate was 100％.Intraoperative bleeding was seen in one case (200 ml),managed by nonsurgical method,including electrocoagnlation,metal clips and nylon rope.Perforation occurred in 1 case during the procedure and was managed by metal clips.Delayed bleeding occurred in 1 case in the second day and was managed endoscopically.During a median followup of 13 (range,2-39) months,the quality of life was satisfactory in this cohort,and no patients developed long-term complications.There was one recurrence within 1 year after the procedure and a second ESD was performed.Conclusion Endoscopic treatment is technically feasible and may be considered as the procedure of choice for duodenal Brunner adenoma.
