胃小间质瘤内镜黏膜下套吸分离切除术的应用

Application of submucosal ligation and suck endoscopic separated-resection in gastric small stromal tumor

目的探讨内镜黏膜下套吸分离切除术治疗胃小间质瘤的可行性和安全性。方法经内镜下套吸分离切除21例患者胃小间质瘤,免疫组织化学检查标本CD117、CD34和Desmin的表达。术后第7天、第1、3及6个月和1年后分别复查胃镜检查,观察瘤体脱落和创面愈合情况。结果 21例病例中,20个瘤体完全分离,完全分离率为95.2%;1例患者瘤体未能完全分离,但随圈套器脱落而坏死。所有21例患者未出现穿孔、出血等并发症,未出现内镜下复发。结论治疗胃小间质瘤内镜下套吸分离切除术是安全、有效的操作技术,并具有操作简便,并发症少、切除彻底等优点,为胃小间质瘤的治疗提供新方法。

[ Objective ] To determine the feasibility and safety of gastric small stromal tumor treated with submu- cosal ligation and suck endoscopic separated-resection （SLSER）. [Methods] 21 cases of gastric small stromal tu- mors were performed by SLSER. The expressions of CDllT, CD34 and Desmin of the tumors were detected by im- munohistoehemistry. In order to observe the tumor shedding and wound healing, these cases were reviewed by en- doscopy on the 7th day, lst,3rd and 6th month and 1st year of postoperation respectively. [Results] In the 21 cas- es, the tumors of 20 cases were completely separated （95.2%） and only one cannot be totally separated. But it was necroses following the device falling off. None of cases appeared perforation, bleeding and other complications and recurrence under endoscopic examination. [ Conclusions ] It is safety and effective that gastric small stromal tumor treated though S1SER. The technique owns these advantages of simple operation, less complications and complete re- section, ete, which provide a new way for treatment of gastrointestinal stromal tumors （GISTs）.