治疗胃固有肌层肿瘤中改良内镜下黏膜结扎剥离术临床分析

Clinical analysis on the improved endoscopic mucosaligation of decollement in thetreatment of gastric tumor to the muscularis propria

目的探讨改良内镜下肿瘤结扎剥离术(ESD—L)运用于胃固有肌层肿瘤切除术临床分析。方法对44例胃固有肌层肿瘤患者均行ESD—L术切除胃部肿瘤,观察并分析术中和术后相关情况,术后均随访观察治疗效果。结果 44例患者病变部位均完整切除,7例出现穿孔,及时行全层切除并金属夹止血,术后无其他并发症出现。44例均获完整随访观察,未见复发及严重并发症发生。结论改良内镜下黏膜结扎剥离术运用于胃固有肌层肿瘤的切除可以达到完整切除病变部位,剥离病灶,减少术中出血和创面,从而降低因直视下全层切除导致的手术风险,改善治疗效果,提高生活质量。

Objective To investigate the improvement of endoscopic ligation tumor dissection （ESD -L） used in the treatment of gastric muscularis propria Clinical analysis of tumor resection. Methods 44 cases of gastric muscularis propria tumors were retrospectively analyzed for March 2011 to July 2012 in our hospital. After ESD - L, the relevant dissection was observed and analyzed, postoperative follow - up observation treatment. Further dissection was aaplied till the whole tumor was isolated. Results 44 cases were complete resection of the lesion, even patients had intraoperative perforation, time line and fullthickness excision metal clip bleeding, patients without other complications. 44 cases were complete follow - up observation, no recurrence and serious complications. Conclusion The modified technique of RSD - L is effective for complete resection of stomach muscularis propria tumor,which can reduce bleeding,wounds and surgical risk to improve treatment and the quality of life.