摘要
目的探讨内镜下黏膜剥离术(ESD)治疗胃肌层肿块的疗效及安全性。方法分析2008年6月～2011年6月于南昌大学第一附属医院消化内科行ESD治疗胃肌层肿块患者,术前均经超声胃镜诊断,行ESD,术后切除组织均送病理切片检查,并内镜随访。结果共69例,肿块直径0.5～2.0cm;完整切除54例(78.3%),尼龙绳套扎+活检10例(14.5%);术后病理诊断平滑肌瘤39例,间质瘤23例,血管瘤3例,其他4例。出血16例,均行内镜下治疗好转;穿孔7例,均行钛夹闭合和胃肠减压后6例痊愈,1例术后第3天出现明显腹膜炎行外科手术治疗。结论 ESD治疗胃肌层直径小于2.0cm肿块是安全可行的,主要并发症是出血和穿孔,大多可通过内镜下治疗解决。
【Objective】To explore the effect and safety of endoscopic submucosal dissection （ESD） for patients with stomach muscle mass layer. 【Methods】During June, 2008 to June, 2011, the patients with stomach muscle mass layer underwent ESD in the Digestive Department First Affiliated Hospital of Nanchang University. The patients were diagnosed with ultrasound gastroscopic examination and followed up by endoscopy. The resection tissues were sent to pathological examination. 【Results】There were 69 patients included. Diameter of the mass was about 0.5~2.0 cm. Complete resection 54 cases （78.3%）, nylon cord ligation and biopsy 10 cases （14.5%）. Pathological diagnosis after the treatment were thirty-nine liomyoma, twenty-three mesenchymoma, three hemangioma, four other else. The complications were sixteen haemorrhage that got better with endoscopic treatment, seven perforations that got titanium enclosed and decompression. As a result, six perforations got recovered and one presented with obvious peritonitis on the third day thus transferred for surgery. 【Conclusions】It＇s safe and feasible for the stomach muscular mass which were smaller than 2.0 cm in diameter to get ESD. The major complications were haemorrhage and perforation, most of which could be resolved under endoscopy.
出处
《中国内镜杂志》
CSCD
北大核心
2013年第1期53-55,共3页
China Journal of Endoscopy
关键词
内镜下黏膜剥离术
胃肌层肿块
endoscopic submucosal dissection
stomach muscular mass
