经内镜黏膜下不同术式治疗贲门周围黏膜下肿瘤疗效分析

Analysis of the therapeutic effect of different endoscopic submucosal operations on submucosal tumors around cardia

目的探讨经内镜黏膜下肿瘤隧道切除术(STER)、内镜黏膜下剥离术(ESD)治疗贲门周围黏膜下肿瘤的临床疗效。方法选取北部战区总医院内窥镜科自2016年7月至2020年10月收治的52例接受内镜治疗贲门周围黏膜下肿瘤患者为研究对象。根据不同手术方式将其分为STER组(n=18)与ESD组(n=34)。记录并比较两组患者的临床疗效、术后并发症发生情况及随访情况。结果STER组患者的手术用时多于ESD组,差异有统计学意义(P<0.05)。两组患者缝合夹数量、完整切除比例、住院时间、住院费用、短期并发症发生比例比较,差异均无统计学意义(P>0.05)。STER组、ESD组患者长期并发症总发生率分别为5.55%(1/18)、5.88%(2/34),组间比较,差异无统计学意义(P>0.05)。52例贲门周围黏膜下肿瘤患者中,以平滑肌瘤最为常见,共36例(69.23%),其次为间质瘤11例(21.15%)。结论ESD与STER治疗贲门周围黏膜下肿瘤均有良好的临床疗效,具有手术创伤小、恢复快、术后并发症少的特点,但ESD手术治疗过程更快。

Objective To investigate the clinical efficacy of endoscopic submucosal tunneling resection(STER)and endoscopic submucosal dissection(ESD)in the treatment of submucosal tumors around cardia.Methods Fifty-two patients with submucosal tumors around cardia treated by endoscopy from July 2016 to October 2020 in the department of endoscopy of General Hospital of Northern Theater Command were selected as the research subjects.According to different surgical methods,they were divided into STER group(n=18)and ESD group(n=34).Clinical efficacy,postoperative complications and follow-up were recorded and compared between the two groups.Results The operation time of STER group was longer than ESD group,and the difference was statistically significant(P<0.05).There were no significant differences in the number of suture clips,proportion of complete resection,length of hospital stay,hospitalization cost and proportion of short-term complications between two groups(P>0.05).The total incidence of long-term complications in STER group and ESD group was 5.55%(1/18)and 5.88%(2/34),respectively,with no statistical significance(P>0.05).Among the 52 patients with submucosal tumor around cardia,leiomyoma was the most common,in 36 cases(69.23%),followed by stromal tumor in 11 cases(21.15%).Conclusion Both ESD and STER have good clinical efficacy in the treatment of submucosal tumors around cardia,with the characteristics of less surgical trauma,quick recovery and less postoperative complications,but ESD surgery is faster.