摘要
目的观察经食管黏膜下隧道切除贲门周围固有肌层良性肿瘤的手术效果，总结经验。方法回顾性分析2012年1月至2013年10月解放军总医院和解放军第二五二医院消化内镜中心内镜及超声内镜诊断贲门周围固有肌层良性肿瘤17例患者资料，其中男7例，女10例，平均年龄42．1岁，均采用经食管黏膜下隧道切除病变，观察术中病变形态，总结技术要点，分析及对比并发症发生率。结果病变直径0．8-3．5cm（平均1．6em），所有病例均成功切除，其中11例一次性完整切除，6例分块切除，术后复查无复发。手术时间26-105min（平均43min）。病变形态规则（呈球形或椭球形）5例，形态不规则（呈多角分叶形等）12例。术中均有少量出血，采用电凝可成功止血，无一例内镜下无法控制的大出血；切除病变后固有肌层缺失仅剩一层薄膜3例，钛夹封闭隧道入口起到良好的保护创面作用；无一例穿孔病例；皮下气肿3例，术后1d内均能自动吸收；气腹3例，予腹腔穿刺放气后，保守治疗后出院。结论经食管黏膜下隧道切除贲门周围固有肌层良性肿瘤是一种安全、可靠、便捷的内镜手术方法。
Objective To summarize the experiences of resecting cardiac muscularis propria benign tumors though esophageal submucosal tunnel and examine the occurrence rate of complications. Methods A total of 17 cases of cardiac muscularis propria benign tumor as diagnosed by endoscopy and endoscopic ultrasonography underwent endoscopic submucosal tunnel dissection from January 2012 to October 2013. And the appearances of lesions and the operative complications were recorded and analyzed. Results All lesions were successfully resected with a mean diameter of 1.6 （ 0. 8 - 3.5 ） cm. There was no recurrence. The mean operative duration was 43 （ 26 - 105 ） rain. The appearances of lesions were regular （ n = 5 ） and irregular （n = 12）. There was no instance of severe bleeding or perforation. Resection of mnscularis propria was performed for 3 cases. The complications included pneumoderm （ n = 3 ） and pneumoperitoneum （ n = 3）. All the above cases were discharged after conservative treatment. Conclusion Endoscopic submucosal tunnel dissection is safe, reliable, convenient and fast for cardiac muscularis propria tumors method.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第46期3655-3657,共3页
National Medical Journal of China
关键词
内窥镜检查
胃肠道
贲门
固有肌层肿瘤
内镜黏膜下隧道法剥离术
Endoscopy, gastrointestinal
Cardia
Submucosal tumors originating frommuscularis propria
Endoscopic submucosal tunnel dissection
