内镜经黏膜下隧道切除术及黏膜下挖除术在贲门固有肌层肿瘤治疗中的比较

The comparison of submucosal tunneling endoscopic resection and endoscopic submucosal excavation in the treatment of cardia muscularis propria tumor

目的针对内镜经黏膜下隧道切除术(STER)及内镜黏膜下挖除术(ESE)在贲门固有肌层肿瘤治疗的疗效及安全性加以比较。方法回顾性分析本院内镜中心自2014年6月～2017年3月因贲门固有肌层肿瘤行STER(16例)或ESE(23例)治疗的患者。结果两组患者在年龄、肿瘤病理类型分布上同样差异无统计学意义。39例患者均实现一次性切除,完整切除率为100%,ESE组患者中有2例在剥离过程中发生穿孔,经金属钛夹封闭的方式妥善处理。STER治疗组和ESE治疗组患者在切除的肿瘤直径、住院总天数上差异无统计学意义。在手术操作时间、术中出血量两项指标上,STER组数值均显著小于ESE组(P<0.05)。结论 STER和ESE相比,STER更为安全、有效。

Objective To compare the efficacy and safety of endoscopic submucosal tunneling （STER） and endoscopic submucosal dissection （ESE） in the treatment of cardia muscularis propria tumor. Methods Retrospective analysis was carried out to investigate the efficacy and safety for patients who suffering from cardia muscularis propria tumor treatmenting with STER （16 cases） or ESE （23 cases） between June 2014 and March 2017. Results There was no statistically significant difference between the two groups of patients in age and tumor pathological type distribution. In all 39 cases, the total removal rate was 100%, 2 cases in ESE group were perforated in the process of stripping and treated with metal titanium clamp. There was no statistical difference in the diameter of tumor resection and total number of hospital stay in patients treated by STER treatment group and ESE treatment group. The numerical value of STER group was significantly lower than that of ESE group （P 〈 0.05） in the operation time and in- traoperative blood flow. Conclusion Compared with ESE, STER was safer and more effective.