纵轴超声内镜指导胃黏膜下间质瘤套扎126例

Longitudinal endoscopic ultrasonography-guided endoscopic band ligation of gastric stromal tumors:an analysis of 126 cases

目的:评价纵轴超声内镜指导胃黏膜下间质瘤的套扎和随访.方法:经纵轴超声内镜检查诊断筛选胃黏膜下小间质瘤126例,胃贲门8例,胃底45例,胃体39例,胃窦34例,行内镜下黏膜套扎术治疗,于术后、术后1-2mo,半年,每一年随访观察.结果:部分细针穿刺组织,病理符合率为100%,进行胃黏膜下间质瘤的套扎术,成功124例,成功率98.4%,超声内镜随访间质瘤消除125例,随访清除率99.2%.有86例患者经1-5年随访,套扎瘤局部平滑,11例可见条状白瘢,其余患者局部黏膜未见不同,未发现残留、复发等,治愈率99.2%.结论:在超声内镜检查指导下对胃黏膜下间质瘤定性、定位、定体积,选择内镜下套扎治疗,随访观察治愈率高.该方法安全、有效、简便,值得进一步规范推广.

AIM：To evaluate the feasibility of longitudinal endoscopic ultrasonography（EUS）-guided endoscopic band ligation of gastric submucosal stromal tumors（GISTs）.METHODS：One hundred and twenty-six patients with GISTs underwent EUS-guided endoscopic band ligation.Tumors were located in the cardia in 8 patients,in the fundus in 45 patients,in the corpus in 39 patients,and in the antrum in 34 patients.The follow-up was performed on day 1,at 1,2,6 and 12 mo after band ligation and every year thereafter.RESULTS：The diagnosis of GISTs was confirmed by EUS-guided fine needle biopsy in several patients.The success rate of endoscopic band ligation was 98.4%（124/126）.Tumor eradication was found in 125 patients（99.2%） during follow-up.During 1-5 years of follow-up,the ligation site became flat in 86 patients,and formed white strip scar in 11 patients.No residual or recurrent tumors were found,and the recovery rate was 99.2%.CONCLUSION：EUS-guided endoscopic band ligation is a safe,effective and simple approach for treatment of GISTs.