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目的:探讨上消化道固有肌层黏膜下肿瘤(SMT)应用微探头超声内镜(EUS)下圈套结扎联合剥离治疗的临床效果。方法选择经EUS检查确认来源于固有肌层的SMT患者12例,应用微探头超声内镜下圈套结扎病变,预切开病变表面黏膜;剥离黏膜下层组织以显露病变,再完整将病变切除。结果本组上消化道固有肌层的SMT患者12例,病变直径0.7～1.4cm,平均(1.1±0.2)cm。术后病理诊断:胃间质瘤6例、胃平滑肌瘤3例、胃血管球瘤l例、食管平滑肌瘤2例。12例均一次性完整切除病变,其中l例术后出现消化道穿孔,应用金属夹成功夹闭。结论来源于上消化道固有肌层的SMT(直径<1.5cm)应用微探头EUS指导下圈套结扎联合剥离治疗是安全有效的,病变可被完整切除,且能提供完整病理学诊断资料,达到与外科手术相同的治疗效果。
Objective: To investigate the clinical effect of submerged muscularis submucosal tumor (SMT) in the upper digestive tract treated with snare and ligation under microendoscopic endoscopic ultrasonography (EUS). Methods Twelve cases of SMT patients confirmed by EUS examination were selected from the muscularis propria. Ultrasound endoscopic ultrasonography was used to ligate the lesion and precut the diseased surface mucosa. The submucosal tissue was dissected to reveal the lesion, and then the lesion was completely excised. Results In this group, 12 patients with SMT in the upper gastrointestinal muscularis mucosa had a diameter of 0.7 ~ 1.4 cm (mean, 1.1 ± 0.2 cm). Postoperative pathological diagnosis: gastric stromal tumors in 6 cases, 3 cases of gastric leiomyoma, gastric glomus in 1 case, 2 cases of esophageal leiomyoma. Twelve cases were complete one-time complete resection of lesions, including l cases of postoperative gastrointestinal perforation, the use of metal clip successfully clipped. Conclusion The SMT (diameter <1.5cm) originating from the muscularis propria of the upper digestive tract is safe and effective under the guidance of the EUS-guided snare probe combined with stripping. The lesion can be completely excised and can provide complete pathological diagnosis data Surgery same treatment effect.