CAJ | 학술논문

目的探讨经内镜黏膜下隧道肿瘤切除术(STER)治疗食管固有肌层肿瘤的疗效及临床应用价值.方法分析福建省立消化内镜中心经胃镜及超声胃镜证实食管固有肌层肿瘤,按照知情同意原则并接受STER治疗的患者28例,标本予以病理学检查明确诊断,术后随访观察疗效及安全性.结果 28例均由STER完整切除,肿瘤大小1.0～6.0cm,手术时间(黏膜切开至黏膜隧道完全封闭)27 ～115 min,平均71 min,隧道长度为3～8 cm,平均隧道长度为4.3 cm.完整缝合窗口所用金属夹6 ～15枚,平均10枚.完整切除率100％.术后病理检查证实27例为平滑肌瘤,l例为颗粒细胞瘤,切缘均阴性.除1例出现皮下气肿(经保守治疗后愈合),余术后均未出现出血、感染等并发症.术后随访0 ～21个月,无病变残留或复发.结论 STER治疗食管固有肌层肿瘤具有完整切除率高、手术时间短、并发症少等优点.
목적 탐토경내경점막하수도종류절제술(STER)치료식관고유기층종류적료효급림상응용개치.방법 분석복건성립소화내경중심경위경급초성위경증실식관고유기층종류,안조지정동의원칙병접수STER치료적환자28례,표본여이병이학검사명학진단,술후수방관찰료효급안전성.결과 28례균유STER완정절제,종류대소1.0～6.0cm,수술시간(점막절개지점막수도완전봉폐)27 ～115 min,평균71 min,수도장도위3～8 cm,평균수도장도위4.3 cm.완정봉합창구소용금속협6 ～15매,평균10매.완정절제솔100％.술후병리검사증실27례위평활기류,l례위과립세포류,절연균음성.제1례출현피하기종(경보수치료후유합),여술후균미출현출혈、감염등병발증.술후수방0 ～21개월,무병변잔류혹복발.결론 STER치료식관고유기층종류구유완정절제솔고、수술시간단、병발증소등우점.
Objective To investigate the efficacy and clinical application value of submucosal tunneling endoscopic resection (STER) for esophageal tumors originating from muscularis propria.Methods A total of 28 patients with esophageal tumors originating from muscularis propria by gastroscope and endoscopic ultrasonography have signed informed consents and accepted STER.The specimens were definite for pathological diagnosis,and postoperative therapeutic effect and safey were followed up.Results Esophageal tumors were completely resected through STER in 28 cases.The size of tumors was about 1.0-6.0 cm in length,and the operating time of tunnel mucosal incision to mucosal closure was 27 to 115 min (mean 71 min).The length of tunnel was 3-8 cm (mean 4.3 cm).Six to fifteen (mean 10) hemostatic clips were used to close mucosal incision site.The rate of complete resection was 100％.Of the 28 patients,27 cases were pathologically proven to be leiomyoma and 1 case to be granular cell tumor with all the cutting edges negative.One patient developed subcutaneous emphysema,and cured by the conservative treatment.No complications such as gastrointestinal bleeding after operation,and infection occurred in the rest cases.During a postoperative follow-up period of 0-21 months,there was no recurrence or residual lesions.Conclusion STER for esophageal tumors originating from muscularis propria is of shorter operating time,less bleeding,small trauma and fewer complications.