CAJ | 학술논문

目的：探讨内镜全层切除术（EFR）对胃固有肌层间质瘤的治疗价值。方法选取2011年2月至2013年8月于烟台毓璜顶医院消化内镜中心行胃镜检查发现并经超声胃镜、CT 或MRI 检查，提示为胃固有肌层间质瘤患者18例，在气管插管全麻下行 EFR 治疗，术后随访评价其疗效及安全性。结果经 EFR 治疗的18例患者，病变均一次性完整切除。切除肿瘤最大直径1.2～3.0 cm，平均最大直径为1.8 cm。EFR 手术时间为45～120 min，平均手术时间为85.5 min。术后病理证实2例位于胃体的肿瘤为平滑肌瘤，其余均为间质瘤。术后均未出现出血、腹膜炎等并发症。术后随访1～12个月，创面愈合良好，病变均无残留或复发。结论 EFR 治疗胃固有肌层间质瘤安全、有效，具有创伤小、整体切除率高的优点，具有良好的临床推广价值。
목적：탐토내경전층절제술（EFR）대위고유기층간질류적치료개치。방법선취2011년2월지2013년8월우연태육황정의원소화내경중심행위경검사발현병경초성위경、CT 혹MRI 검사，제시위위고유기층간질류환자18례，재기관삽관전마하행 EFR 치료，술후수방평개기료효급안전성。결과경 EFR 치료적18례환자，병변균일차성완정절제。절제종류최대직경1.2～3.0 cm，평균최대직경위1.8 cm。EFR 수술시간위45～120 min，평균수술시간위85.5 min。술후병리증실2례위우위체적종류위평활기류，기여균위간질류。술후균미출현출혈、복막염등병발증。술후수방1～12개월，창면유합량호，병변균무잔류혹복발。결론 EFR 치료위고유기층간질류안전、유효，구유창상소、정체절제솔고적우점，구유량호적림상추엄개치。
Objective To study the therapeutic value of endoscopic full-thickness resection for gastric stromal tumor. Methods From February 2011 to August 2013, 18 cases of patients with gastric stromal tumors originating from the muscularis propria layer were detected by endoscopic ultrasonography, CT and MRI in Yantai Yuhuangding Hospital, then treated with endoscopic full-thickness resection(EFR) after intubation anesthesia. The patients were followed up with gastrocope for evaluation of therapeutic effect and safty. Results EFR was successfully accomplished to remove all tumors in 18 patients. The size of tumors ranged from 1.2 to 3.0 cm ( mean 1.8 cm) in diameter. The mean procedure time was 85.5min(45 ~ 120min).Except in 2 leiomyomas,pathological examination confirmed gastric stromal tumor in 16 cases. None of patients had occurred bleeding, peritonnitis and other complications after EFR. Thereafter, all patients were followed up with gastrocope after 1 ~ 12 months. Lesions healed well, no residual or recurrence. Conclusion EFR is effective and safe for patients with gastric stromal tumors originated from muscularis propria layer and has the advantage of less invasive treatment and higher tumor resection rate. It should be popularized in the future.