内镜全层切除术治疗胃固有肌层肿瘤的应用价值

Clinical value of endoscopic full-thickness resection in treatment of gastric tumor originating from muscularis propria

目的探讨内镜全层切除术(EFTR)在胃固有肌层肿瘤治疗中的应用价值。方法对28例经胃镜、微探头超声内镜及腹部CT等检查证实的胃固有肌层来源的肿瘤患者采用内镜下全层切除术(EFTR)进行治疗。结果 28例患者的胃固有肌层肿瘤均经内镜全层切除术得到完整切除,创面均用尼龙绳联合钛夹荷包缝合进行闭合,无中转外科手术病例;肿瘤位于胃底25例,胃体3例;肿瘤直径0.8~4.0 cm。术后病理证实胃肠间质瘤(GIST)24例,平滑肌瘤4例。均随访6个月,手术创面愈合,未见肿瘤复发。结论 EFTR治疗胃固有肌层肿瘤疗效肯定,是微创、安全、有效的治疗方法。

Objective To explore the clinical value of endoscopic full-thickness resection（ EFTR） in the treatment of gastric tumor originating from muscularis propria. Methods Twenty-eight patients with gastric tumors originating from muscularis propria were confirmed by endoscopy, miniprobe endoscopic ultrasonography and abdominal CT scan. All the patients underwent EFTR. Results The gastric tumors originating from muscularis propria of 28 patients were completely removed by EFTR,and the wound surface was closed by purse string suture using nylon rope and titanium clips. No conversion to surgery occurred. The lesions located at gastric fundus and gastric body were found in 25 cases and 3 cases respectively. The diameters of tumors were 0. 8-4. 0 cm. Twenty-four cases and 4 case were confirmed as astrointestinal stromal tumor and liomyoma by postoperative pathology respectively. The patients were followed-up for six months.The surgical wound surface healed,and no tumor recurrence occurred. Conclusion EFTR obtains a definite efficacy for gastric tumor originated from muscularis propria,and is a minimally invasive,safe and effective treatment.