CAJ | 학술논문

目的初步探讨内镜下结扎剥离技术治疗胃固有肌层来源小肿瘤的有效性和安全性.方法对33例患有胃固有肌层来源1 cm以下肿瘤的患者进行内镜下结扎剥离治疗.用皮圈结扎瘤体,之后用钩刀或IT刀对瘤体进行剥离,直到瘤体完全或部分剥离出来,标本送组织学检查,创面以金属夹和医用胶封闭.分别于术后1周、1个月、3个月、6个月、12个月进行内镜检查观察瘤体脱落情况及创面愈合情况.结果 33个病例中,25个瘤体内镜下部分剥离,8个瘤体内镜下完整剥离,33个瘤体均随着皮圈套完整脱落,所有病例均获得了确切的病理学诊断.1例患者出现自限性的出血,未出现穿孔等并发症.术后随访3 ～18个月,无复发患者.结论内镜下结扎剥离是治疗胃固有肌层来源肿瘤安全、有效,而且相对简单的技术,优势在于为病变提供了组织病理学诊断.
목적 초보탐토내경하결찰박리기술치료위고유기층래원소종류적유효성화안전성.방법 대33례환유위고유기층래원1 cm이하종류적환자진행내경하결찰박리치료.용피권결찰류체,지후용구도혹IT도대류체진행박리,직도류체완전혹부분박리출래,표본송조직학검사,창면이금속협화의용효봉폐.분별우술후1주、1개월、3개월、6개월、12개월진행내경검사관찰류체탈락정황급창면유합정황.결과 33개병례중,25개류체내경하부분박리,8개류체내경하완정박리,33개류체균수착피권투완정탈락,소유병례균획득료학절적병이학진단.1례환자출현자한성적출혈,미출현천공등병발증.술후수방3 ～18개월,무복발환자.결론 내경하결찰박리시치료위고유기층래원종류안전、유효,이차상대간단적기술,우세재우위병변제공료조직병이학진단.
Objective To evaluate the efficacy and safety of ligation-assisted endoscopic dissection (ED-L) technique for the removal of gastric tumors originating from muscularis propria.Methods A total of 33 patients with gastric tumors originating from muscularis propria less than 10 mm were treated with ED-L procedures.The tumor was ligated by elastic bands.Endoscopic dissection was performed until the tumor was partially or completely dissected from muscularis propria by using Hook knife and/or IT-knife.The wound was closed with metallic clips and medical adhesive.The patients were followed up 1 week,1 month,3 months,6 months and 12 months thereafter with endoscopy,respectively.Results Of the 33 gastric tumors,there were 25 partial dissections and 8 complete dissections.All of the tumors sloughed completely.Pathological diagnoses of all the patients were acquired.No complications like perforation occurred except for one self-limiting and non-life-threatening hemorrhage.There was no recurrent case during the 3-18 months of follow-up period.Conclusion ED-L is a safe,effective and relatively simple technique for excision of small gastrointestinal tumors originating from muscularis propria,providing a histopathological diagnosis as well.