中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2011年
6期
309-312
,共4页
外套管%食管上段胃黏膜异位症%内镜治疗
外套管%食管上段胃黏膜異位癥%內鏡治療
외투관%식관상단위점막이위증%내경치료
Wrapper tube%Upper esophageal mucosal endometriosis%Endoscopic therapy
目的 探讨外套管辅助内镜直视下黏膜切除术治疗食管上段胃黏膜异位症的临床价值.方法 选择经内镜检查和病理证实为食管上段胃黏膜异位症并伴有局部症状的患者53例进行内镜治疗,将外套管套在内镜外,随内镜一起插入患者食管内,将内镜退至外套管内,边退外套管边观察,见外套管头部刚好退至病变部位口侧,固定外套管,行内镜下黏膜切除术.术后随访观察疗效.结果 53例患者采用一次性切除者45例,2次切除者5例,3次切除者3例.平均每例所需时间为6.5 min(4.5～7.5 min),内镜下完全切除率达100%.术后3个月随访时43例症状消失,占81.1%; 6个月随访时45例症状消失,占85%.内镜及活检病理均未见复发.无食管狭窄、穿孔及心肺意外等并发症.结论 食管上段胃黏膜异位症合并局部症状者,采用外套管辅助固定内镜直视下黏膜切除具有手术简便、创伤小、恢复快、疗效确切的特点.
目的 探討外套管輔助內鏡直視下黏膜切除術治療食管上段胃黏膜異位癥的臨床價值.方法 選擇經內鏡檢查和病理證實為食管上段胃黏膜異位癥併伴有跼部癥狀的患者53例進行內鏡治療,將外套管套在內鏡外,隨內鏡一起插入患者食管內,將內鏡退至外套管內,邊退外套管邊觀察,見外套管頭部剛好退至病變部位口側,固定外套管,行內鏡下黏膜切除術.術後隨訪觀察療效.結果 53例患者採用一次性切除者45例,2次切除者5例,3次切除者3例.平均每例所需時間為6.5 min(4.5～7.5 min),內鏡下完全切除率達100%.術後3箇月隨訪時43例癥狀消失,佔81.1%; 6箇月隨訪時45例癥狀消失,佔85%.內鏡及活檢病理均未見複髮.無食管狹窄、穿孔及心肺意外等併髮癥.結論 食管上段胃黏膜異位癥閤併跼部癥狀者,採用外套管輔助固定內鏡直視下黏膜切除具有手術簡便、創傷小、恢複快、療效確切的特點.
목적 탐토외투관보조내경직시하점막절제술치료식관상단위점막이위증적림상개치.방법 선택경내경검사화병리증실위식관상단위점막이위증병반유국부증상적환자53례진행내경치료,장외투관투재내경외,수내경일기삽입환자식관내,장내경퇴지외투관내,변퇴외투관변관찰,견외투관두부강호퇴지병변부위구측,고정외투관,행내경하점막절제술.술후수방관찰료효.결과 53례환자채용일차성절제자45례,2차절제자5례,3차절제자3례.평균매례소수시간위6.5 min(4.5～7.5 min),내경하완전절제솔체100%.술후3개월수방시43례증상소실,점81.1%; 6개월수방시45례증상소실,점85%.내경급활검병리균미견복발.무식관협착、천공급심폐의외등병발증.결론 식관상단위점막이위증합병국부증상자,채용외투관보조고정내경직시하점막절제구유수술간편、창상소、회복쾌、료효학절적특점.
Objective To Investigate the safety and clinical significance of self-made wrapper tube assisted endoscopic mucosal resection for upper esophageal mucosal endometriosis.Methods A total of 53 patients with upper esophageal mucosal endometriosis and the corresponding symptoms, which was confirmed by endoscopy and pathology, underwent endoscopic treatment.The endoscope was inserted into the esophagus together with wrapper tube.Then the endoscope was retreated into the wrapper tube and pulled back together with the tube.When the tip of the wrapper tube reached at the oral side of the lesion, it was fixed, and submucosal resection was performed.All patients were followed up to 6 months.Results All lesions were completely resected, which was achieved by one session in 45 patients, by two in 5, and by three in 3 other patients, with a mean procedure time at 6.5 minutes (4.5-7.5).Symptoms were relieved in 43 patients (81.1%) at 3 months after the procedure, and in 45 patients (85%) at 6 months.No local recurrence was observed under endoscopy and biopsy.No complications including esophageal stenosis, perforation or cardiopulmonary accidence were recorded. Conclusion For upper esophageal mucosal endometriosis presented with local symptoms, wrapper tube assisted endoscopic mucosal resection is safe, less invasive, easy to manipulate and effective.
