内镜黏膜下剥离术治疗食管平滑肌瘤的疗效分析

Analysis of efficacy of endoscopic submucosal dissection for esophageal leiomyoma

目的探讨内镜黏膜下剥离术（ESD）治疗食管平滑肌瘤的疗效和安全性。方法对30例确诊为食管平滑肌瘤患者行ESD治疗，观察病灶切除情况、手术时间、术中及术后并发症等情况。结果30例患者的病灶直径为1．5～2．5cm（平均2．0cm），均经ESD一次性完整切除。手术时间30~90min（平均60min）。术中少量出血均经电凝及热活检钳止血，3例出血较多，术后内镜下金属夹止血。所有ESD剥离病变包膜完整，基底和切缘未见病变累及。术后随访6月无复发。结论内镜黏膜下剥离术治疗食管平滑肌瘤是一种安全、有效的方法。

Objective To evaluate the efficacy and safety of endoscopic submucosal dis.sec- tion （ESD） for esophageal leiomyoma. Methods Thirty cases of esophageal leiomyomas were treat- ed with ESD. The dissection condition, operation time, complications during and after operation were observed. Results Of 30 cases of esophageal leiomyomas, lesions ranged from 1.5 to 2.5 em （mean resected size was 2.0 cm）. All these cases were resected en bloc and the operation time was from 30 to 90 minutes （mean time was 60 minutes）. Intraoperative minimal hemorrhage could be stopped with electric coagulation or hot biopsy clamp. Three cases had massive hemorrhage, which were typically stopped with metallic endoclips. Histological evaluation showed that the tunica of the tumors was intact, and both the lateral and basal margins of the specimens were free of tumor cells. Patients were followed up 6 month and no recurrence was found. Conclusion ESD is an efficacious and safe endoscopic surgical procedure for the treatment of esophageal leiomyoma.