中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2014年
5期
18-20
,共3页
内镜黏膜下剥离术%平滑肌瘤%胃固有肌层
內鏡黏膜下剝離術%平滑肌瘤%胃固有肌層
내경점막하박리술%평활기류%위고유기층
Endoscopic submucosal dissection%Gastric leiomyoma%Muscularic propria layer
目的：探讨内镜黏膜下剥离术（ESD）治疗来源于胃固有肌层平滑肌瘤的疗效与安全性。方法选取2013年7月至2014年6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检查提示胃固有肌层平滑肌瘤的19例患者，在气管插管静脉麻醉下行ESD治疗，术后随访评价其疗效及安全性。结果19例来源于胃固有肌层的消化道黏膜下肿瘤（SMT）均成功剥离，1例出现穿孔，应用金属钛夹成功夹闭。术后病理诊断：平滑肌瘤，其中胃体12例，胃底3例，胃窦4例。病变最大直径0.8～4.3 cm，平均最大直径为2.5 cm。ESD操作时间40～150 min，平均操作时间为76.8 min。19例手术中均有少量出血，术后均未出现严重并发症。结论 ESD治疗来源于胃固有肌层平滑肌瘤安全、有效，创伤小，整体切除率高，具有较好的临床推广价值。
目的：探討內鏡黏膜下剝離術（ESD）治療來源于胃固有肌層平滑肌瘤的療效與安全性。方法選取2013年7月至2014年6月于煙檯毓璜頂醫院消化內鏡中心行胃鏡檢查髮現併經超聲胃鏡、CT檢查提示胃固有肌層平滑肌瘤的19例患者，在氣管插管靜脈痳醉下行ESD治療，術後隨訪評價其療效及安全性。結果19例來源于胃固有肌層的消化道黏膜下腫瘤（SMT）均成功剝離，1例齣現穿孔，應用金屬鈦夾成功夾閉。術後病理診斷：平滑肌瘤，其中胃體12例，胃底3例，胃竇4例。病變最大直徑0.8～4.3 cm，平均最大直徑為2.5 cm。ESD操作時間40～150 min，平均操作時間為76.8 min。19例手術中均有少量齣血，術後均未齣現嚴重併髮癥。結論 ESD治療來源于胃固有肌層平滑肌瘤安全、有效，創傷小，整體切除率高，具有較好的臨床推廣價值。
목적：탐토내경점막하박리술（ESD）치료래원우위고유기층평활기류적료효여안전성。방법선취2013년7월지2014년6월우연태육황정의원소화내경중심행위경검사발현병경초성위경、CT검사제시위고유기층평활기류적19례환자，재기관삽관정맥마취하행ESD치료，술후수방평개기료효급안전성。결과19례래원우위고유기층적소화도점막하종류（SMT）균성공박리，1례출현천공，응용금속태협성공협폐。술후병리진단：평활기류，기중위체12례，위저3례，위두4례。병변최대직경0.8～4.3 cm，평균최대직경위2.5 cm。ESD조작시간40～150 min，평균조작시간위76.8 min。19례수술중균유소량출혈，술후균미출현엄중병발증。결론 ESD치료래원우위고유기층평활기류안전、유효，창상소，정체절제솔고，구유교호적림상추엄개치。
Objective The aim of this study was to determine the feasibility of endoscopic submucosal dissection (ESD) for the removal of gastric leiomyoma from the muscularis propria layer and to evaluate the efficacy and safety of ESD for this indication. Methods From July 2013 to June 2014, 19 cases of patients with gastric leiomyoma from the muscularis propria layer were examined by endoscopic ultrasonography (EUS) and CT in Yantai Yuhuanding Hospital,then treated with ESD after intubation anesthesia.The patients were followed up with gastrocope for evaluation of therapeutic effect and safety. Results 19 lesions were completely resected with ESD.Perforation occur in 1 case during the dissection of the lesion, which was successfully closed with metal endoclip without surgical treatment.19 lesions were confirmed gastric leiomyoma after pathological examination. The size of lesions ranged from 0.8 to 4.3 cm with a mean resected size of 2.5 cm. The mean ESD procedure time was 76.8 min (range from 40 to 150 min).All patients had a little of blood loss during ESD.But none of them had other complications after ESD. Conclusion ESD is an effection and safe endoscopic surgical procedure to resect gastric leiomyoma originated from the muscularis propria layer.
