内镜下黏膜下肿块切除对食管胃黏膜下病变的诊疗价值

Therapeutic and diagnostic effects of esophageal and gastric submucosal tumor by endoscopic resection

目的探讨内镜下黏膜下切除治疗食管胃黏膜下隆起性病变的诊断、治疗价值及安全性。方法今年以来该科内镜检查发现食管胃黏膜下隆起性病变20例,结合超声内镜检察结果,在内镜下确定食管胃黏膜下隆起性病变可移动后,于病变基底部注射1∶10000肾上腺素盐水,使病变基底部与胃壁基层分离,用圈套器套取病变,采用混合电凝电切切除隆起性病变。结果18例病人获得有效的病理诊断,大多数患者病变获得有效切除。结论对于食管、胃黏膜下隆起性病变行胃镜下切除术具有良好的诊断与治疗价值,特别对恶性和潜在恶性间质瘤的早期诊断与治疗,安全性较好。

Objective] To evaluate the therapeutic and diagnostic effects and safety of esophageal and gastric submucosal tumor by endoscopic resection. [Methods] 20 patients of esophageal and gastric submucosal tumor who were funded at the department since this year were included in this study. According the results of endoscopic ultrasonography, after the movable of the esophageal and gastric submucosal tumor were affirmed under endoscopy, 1:10 000 adrenaline saline solution were injected with a needle catheter into the submucosa beneath the lesion. En bloc resection was performed for the lesion with high frequency blend wave electrosurgical current. [Results] The histological diagnosis in 18 case was obtained and the lesion in most of they was completely resected. No serious complication was occurred. [Conclusion] Endoscopic resection proved to be an effective and safe method to histological diagnosis and therapy of esophageal and gastric submucosal tumor, specially for the malingnancy and potential malingnancy.