论文部分内容阅读
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。“,”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.