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目的:观察套扎器辅助性内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗胃底固有肌层胃肠道间质瘤(gastrointestinal stromal tumor,GIST)的效果。方法:选取35例经超声内镜检查诊断来源胃底固有肌层的GIST病例,瘤体直径0.5~1.3 cm,实验组17例以7连环套扎器行内镜下GIST套扎,套扎后用超声内镜证实GIST完整套入圈套中,再行ESD;对照组18例直接行ESD治疗。结果:35例患者均一次性顺利完整切除病变,两组在手术耗时、术中出血量方面差异有统计学意义(P<0.05),所有患者接受随访3~24个月,未见病灶残留和复发。结论:套扎器辅助性ESD在胃底GIST切除中,方法简便、安全、有效,并发症少,值得临床广泛应用。
Objective: To observe the effect of ligation assisted endoscopic submucosal dissection (ESD) on the gastrointestinal stromal tumor (GIST) in the gastric muscular lamina propria. Methods: Twenty-five GIST patients with gastric myogenic origin diagnosed by endoscopic ultrasonography were selected. The diameter of the tumor was 0.5 ~ 1.3 cm. Seventeen patients underwent GIST ligation with a seven-tiered ligation in the experimental group. After ligation Ultrasound endoscopy confirmed GIST intact into the trap, and then ESD; control group of 18 patients underwent ESD treatment. Results: Thirty-five patients had complete and one-time successful resection of the lesion. There was significant difference between the two groups in the operation time and blood loss in operation (P <0.05). All the patients were followed up for 3-24 months without any residual lesions And relapse. Conclusion: Ligation assisted ESD in GIST resection of the stomach, the method is simple, safe, effective, less complications, it is widely used in clinical.