超声内镜及内镜下黏膜切除术在食管黏膜肌层平滑肌瘤中的应用

Application of endoscopic ultrasonography and endoscopic mucosal resection in treatment of esophageal mucosal muscular layer liomyoma

目的探讨超声内镜(EUS)对食管平滑肌瘤的诊断价值及内镜下黏膜切除术(EMR)治疗的效果。方法对经EUS检查拟诊为黏膜肌层平滑肌瘤进行EMR治疗的病例资料进行回顾性研究,分析病变部位的EUS图像、病理诊断结果及治疗效果。结果 38例患者病变均完整一次性切除,病理均提示为起源于黏膜肌层的平滑肌瘤,术中基底部渗血5例,经处理后出血停止,无穿孔发生,术后复查胃镜所有病例创面愈合良好,无其他并发症发生。结论 EUS诊断食管平滑肌瘤准确率高,EMR是治疗食管平滑肌瘤的微创、安全、有效、快捷的治疗手段。

Objective To discuss the value of endoscopic ultrasonography（EUS） in diagnosis of esophageal liomyoma and the effect of endoscopic mucosal resection（EMR）. Methods Cases of mucosal muscular layer liomyoma diagnosed by EUS were reviewed, and the EUS images, results of pathological diagnosis, and therapeutic effects were analyzed. Results Lesions of 38 patients were completely removed one time, and pathology all indicated muscular layer liomyoma. There were five cases of basal part errhysis during operation, and were controlled without perforation. Wound healing was favorable in all cases by gastroscope reexamination after operation, without other complications. Conclusion EUS has high accuracy rate in diagnosis of esophageal liomyoma, and EMR is a minimally invasive, safe, effective, and convenient method in treatment of esophageal liomyoma.