CAJ | 학술논문

目的评价内镜经黏膜下隧道肿瘤切除术(STER)治疗来源于固有肌层的直肠黏膜下肿瘤(SMT)的临床效果.方法回顾性分析2011年3月至2013年3月间在复旦大学附属中山医院内镜中心行STER术治疗的8例来源于固有肌层的直肠黏膜下肿瘤的临床病理资料.结果 8例STER手术均获成功,肿瘤均一次性完整切除,肿块距肛缘5～15 cm,切除标本最大直径1.0～3.5(平均1.8)cm,手术耗时40～70(平均51)min.术中黏膜穿孔1例,予以金属夹夹闭修补成功.术后出现下肢皮下气肿1例,对症支持治疗2周后完全消退.术后病理诊断:神经鞘瘤3例,平滑肌瘤2例,胃肠间质瘤1例,增生胶原纤维伴结节变性2例.术后随访6～30月未见病变残留或复发.结论采用STER技术切除直肠固有肌层来源的SMT是一种安全、可行、有效的治疗方法.
목적 평개내경경점막하수도종류절제술(STER)치료래원우고유기층적직장점막하종류(SMT)적림상효과.방법 회고성분석2011년3월지2013년3월간재복단대학부속중산의원내경중심행STER술치료적8례래원우고유기층적직장점막하종류적림상병리자료.결과 8례STER수술균획성공,종류균일차성완정절제,종괴거항연5～15 cm,절제표본최대직경1.0～3.5(평균1.8)cm,수술모시40～70(평균51)min.술중점막천공1례,여이금속협협폐수보성공.술후출현하지피하기종1례,대증지지치료2주후완전소퇴.술후병리진단:신경초류3례,평활기류2례,위장간질류1례,증생효원섬유반결절변성2례.술후수방6～30월미견병변잔류혹복발.결론채용STER기술절제직장고유기층래원적SMT시일충안전、가행、유효적치료방법.
Objective To evaluate the clinical value of submucosal tunneling endoscopic resection (STER) for rectal submucosal tumors (SMT) originating from muscularis propria.Methods Clinicopathological data of 8 cases with rectal SMT originating from muscularis propria undergoing STER in our center from March 2011 to March 2013 were analyzed retrospectively.Results En bloc STER was performed successfully in all the 8 cases.The tumors location was 5-15 cm from the edge of anus.The resected specimen size ranged from 1.0 to 3.5 cm (average 1.8 cm).The mean procedure time was 51 min(range,40-70 min).One patient developed mucosa perforation and was repaired with metal clips.One patient developed subcutaneous emphysema in one leg,which was disappeared after two weeks.Postoperative pathological examination revealed schwannoma in 3 cases,leiomyoma in 2 cases,stromal tumor in 1 case,and proliferation of collagen fibers nodular degeneration in 2 cases.Postoperative follow-up ranged from 6 to 30 months and no residual lesion or recurrence was found.Conclusion STER is a safe and effective method for rectal SMT originating from muscularis propria in our initial experience.