CAJ | 학술논문

目的评价对来源于固有肌层的非腔内生长型胃间质瘤施行内镜下切除闭合术治疗的可行性.方法 46例患者经胃镜和超声内镜检查诊断为起源于固有肌层的非腔内生长型胃黏膜下肿瘤,采用内镜下切除闭合术切除肿瘤,行常规病理及免疫组化检查后证实为间质瘤.术后内镜随访,观察治疗效果及有无并发症.结果 46例非腔内生长型胃间质瘤经内镜下切除闭合术治疗后均完全切除,切除后2例保留完整的浆膜层,44例术中遗留切口,切口最大径1.5 cm,行钛夹夹闭切口,予抑酸、胃肠减压、静脉应用抗生素等辅助治疗.病理报告全层切除46例,肿瘤直径为0.5～3.7 cm.44例患者术后48～72 h后进食,未见明显不适;2例术后出现气腹、局限性腹膜炎,其中1例切口1.5 cm患者术后第2天切口裂开,再次钛夹夹闭裂开切口,辅助治疗10～12 d,该2例患者痊愈出院.术后6个月随访,所有患者切口均形成白色溃疡瘢痕.结论对于非腔内生长型胃间质瘤,内镜下切除闭合术是一种安全、经济、创伤小的治疗方式,值得临床推广.
목적 평개대래원우고유기층적비강내생장형위간질류시행내경하절제폐합술치료적가행성.방법 46례환자경위경화초성내경검사진단위기원우고유기층적비강내생장형위점막하종류,채용내경하절제폐합술절제종류,행상규병리급면역조화검사후증실위간질류.술후내경수방,관찰치료효과급유무병발증.결과 46례비강내생장형위간질류경내경하절제폐합술치료후균완전절제,절제후2례보류완정적장막층,44례술중유류절구,절구최대경1.5 cm,행태협협폐절구,여억산、위장감압、정맥응용항생소등보조치료.병리보고전층절제46례,종류직경위0.5～3.7 cm.44례환자술후48～72 h후진식,미견명현불괄;2례술후출현기복、국한성복막염,기중1례절구1.5 cm환자술후제2천절구렬개,재차태협협폐렬개절구,보조치료10～12 d,해2례환자전유출원.술후6개월수방,소유환자절구균형성백색궤양반흔.결론 대우비강내생장형위간질류,내경하절제폐합술시일충안전、경제、창상소적치료방식,치득림상추엄.
Objective To evaluate the feasibility of endoscopic resection and closure for non-intraluminal gastric stromal tumors originating from the muscularis propria layer.Methods Included in the study were 46 patients with gastric submucosal lesions originating from the muscularis propria layer, detected by gastroscopy and endoscopic ultrasonography.The lesions were removed by endoscopic resection and closure, which were further diagnosed as stromal tumor by means of pathologic and immunohistochemical examinations.The patients were followed up with endoscopy for evaluation of therapeutic effect and complications.Results All lesions were successfully removed, with serosa layer remained in 2 cases and full layer resection in other 44, which were all closed by endoscopic clips.Combination managements of acid suppression,gastrointestinal decompression and intravenous antibiotics were applied in all patients.Pathology reports confirmed complete resection of all lesions, with 0.5 to 3.7 cm in diameter.Normal diet was restored in 44 patients 48 ～ 72 h after the procedure.Pneumoperitoneum and focal peritonitis occurred in 2 cases, one of which underwent rupture and was clamped again.The 2 patients recovered after 10-12 days of conservative treatments.Follow-up endoscopy revealed white ulcerous scar in all cases.Conclusion Endoscopic resection and closure therapy is a safe, economic and less invasive treatment for non-intraluminal gastric stromal tumors originating from the muscularis propria layer.