上消化道粘膜下肿瘤的内镜下诊断及治疗进展

Progress of Upper Gastrointestinal Submucosal Tumors in Endoscopic Diagnosis and Treatment

上消化道粘膜下肿瘤(SMTs)临床较为常见,是一类来源于非粘膜层的肿物,有良恶性之分,良性多见。因其表面覆盖正常粘膜组织,常规的内镜下活检只取到粘膜层,难以深达粘膜下层,肿瘤性质难以判定,因此既往多随访观察,肿瘤在短时间内增大或出现明显的临床症状时才予以外科手术治疗。近年来,由于超声胃镜(EUS)技术的发展,SMTs的诊断不仅可以定位,还可以定性。随着内镜下粘膜切除术(EMR)、内镜下粘膜剥离术(ESD)、经口内镜粘膜下隧道肿瘤切除术(STER)等内镜下微创治疗技术的发展,不仅可获得足够的病理标本更加准确的诊断SMTs,还可以安全、高效的切除病变、避免了外科手术的创伤、减轻了经济负担,本文就内镜下对于SMTs的诊断、微创切除SMTs的方法及相关并发症的处理等予以综述。

Upper gastrointestinal submucosal tumors （SMTs） is a kind of more common disease which originate from the submucosa have being divided benign tumor and malignancy tumor, the former is more common.Because of the overlying normal mucosa tissue, it is difficult for the conventional biopsy forceps to get to submucosa .tumorous types is difficult to judge, SMTs have being follow-up in the past, once the tumor getting bigger in short time or causing obvious symptoms,The surgery will be carried out.In recent years, due to the ultrasonic gastroscope （EUS） development, we can easily know where the SMTs originate from and what type is it.With the development of endoscopic mucosal resection （EMR）, endoscopic submucosal dissection （ESD） ,we can not only get the complete tissue for biopsy but also resecting the lesions safety and efficiency, reducing the patients pain and economic burden, this paper is mainly reviewed the endoscopic diagnosis and treatment of upper gastrointestinal SMTs and endoscopic treatment technology.