CAJ | 학술논문

目的：探讨内镜黏膜下剥离术治疗胃固有肌层肿瘤的效果。方法选择张家港市第一人民医院消化内科2013年6月—2015年5月收治的54例胃固有肌层肿瘤患者作为研究对象，根据患者手术意愿分为内镜剥离组与腹腔镜切除组，每组27例。内镜剥离组采用内镜黏膜下剥离术切除肿物，腹腔镜切除组采用腹腔镜切除术切除肿物，对比分析两组术中及术后情况、术后并发症发生情况、预后，并在术前和术后2个月对患者进行生存质量评价。结果与腹腔镜切除组比较，内镜剥离组手术时间短、术中出血量少、切除病变直径小、住院时间短、并发症发生率低，差异均有统计学意义(P<0．05)；术后2个月生活质量总分两组均明显高于术前(P<0．05)，内镜剥离组术后2个月生活质量总分明显高于腹腔镜切除组(P<0．05)；两组肿瘤均完整切除，病理报告肿瘤切缘及基底均为阴性；术后3、6、12个月进行随访，胃镜下观察切口均愈合良好，未发现一例肿瘤残留或复发。结论内镜黏膜下剥离术治疗胃固有肌层肿瘤有效安全，患者创伤小、恢复快的同时还可达到根治的目的。
목적：탐토내경점막하박리술치료위고유기층종류적효과。방법선택장가항시제일인민의원소화내과2013년6월—2015년5월수치적54례위고유기층종류환자작위연구대상，근거환자수술의원분위내경박리조여복강경절제조，매조27례。내경박리조채용내경점막하박리술절제종물，복강경절제조채용복강경절제술절제종물，대비분석량조술중급술후정황、술후병발증발생정황、예후，병재술전화술후2개월대환자진행생존질량평개。결과여복강경절제조비교，내경박리조수술시간단、술중출혈량소、절제병변직경소、주원시간단、병발증발생솔저，차이균유통계학의의(P<0．05)；술후2개월생활질량총분량조균명현고우술전(P<0．05)，내경박리조술후2개월생활질량총분명현고우복강경절제조(P<0．05)；량조종류균완정절제，병리보고종류절연급기저균위음성；술후3、6、12개월진행수방，위경하관찰절구균유합량호，미발현일례종류잔류혹복발。결론내경점막하박리술치료위고유기층종류유효안전，환자창상소、회복쾌적동시환가체도근치적목적。
Objective To investigate the effect of endoscopic submucosal decollement in treatment of gastric muscularis propria tumor. Methods A total of 54 patients diagnosed as having gastric muscularis propria tumor during June 2013 and May 2015 were recruited in this study, and were divided into endoscopic decollement group (n=27) and laparoscopic resection group (n=27) depending on the decision of the patients. The tumors in endoscopic decollement group were removed using endoscopic submucosal decollement, while the tumors in laparoscopic resection group were re-moved using laparoscopic resection. The intraoperative and postoperative conditions, incidence rates of postoperative com-plications and prognosis in the two groups were compared, and the quality of life before and 2 months after the surgery was evaluated. Results Compared with those in laparoscopic resection group, in endoscopic decollement group, the surgery time was significantly shorter, intraoperative blood loss was significantly less, diameters of excisional lesions were smal-ler, and the incidence rate of complications was significantly lower (P<0. 05);the total scores of quality of life in the two groups 2 months after the surgery were significantly higher than those before the surgery (P<0. 05), and the score in the endoscopic decollement group was significantly higher that that in the laparoscopic resection group ( P <0. 05 );tumors in the two groups were completely removed, and pathological results showed that cutting edge and basement were all negative;with follow-up in 3rd, 6th and 12th month after the surgery, incisions healed well under the gastroscope, and no residual tumor or recurrence was found. Conclusion The endoscopic submucosal decollement in treatment of gastric muscularis propria tumor is effective and safe with micro invasion and better recovery.