透明帽辅助内镜下切除术治疗直径≤10 mm胃黏膜下肿瘤的安全性分析

A Retrospective Study of Cap-assisted Endoscopic Resection in the Treatment of Small Gastric Submucosal Tumors≤10 mm

目的在普通胃肠镜检查中常发现直径较小的消化道黏膜下肿瘤(SMT),并且通常采用透明帽辅助内镜下切除术(CER)或内镜下套扎术(EBL)切除肿物。本研究旨在评估CER和EBL治疗直径≤10 mm的胃SMT的安全性。方法回顾性分析胃小SMT患者227例,其中100例接受CER,127例接受EBL,比较两组手术时长、住院时间、住院费用、切除治疗率、并发症发生率及术中出血量等。结果两组患者在住院时间及住院费用上无统计学差异(P>均0.05)。而与EBL组相比,CER组患者手术时间更短(P<0.001),但术中出血量更多(P<0.001),且并发症发生率更高(P<0.01)。结论CER治疗胃小SMT并非一种安全手术,存在潜在风险,在临床中应慎重考虑。

Objective Small gastrointestinal submucosal tumors(SMT)are usually encountered during routine endoscopic procedure,and cap-assisted endoscopic resection(CER)and endoscopic band ligation(EBL)were the two commonly used methods.Therefore,this study aimed to evaluate and compare the safety of CER with EBL for treatment of gastric SMT less than 10mm.Methods A total of 100 patients who underwent CER and 127 patients who underwent EBL for gastric small SMT were retrospectively analyzed.Results There was significant difference in length of stay and cost between the two groups.More blood loss(P<0.001)and higher complication rates(P<0.001),but shorter operating times(P<0.001)were observed for CER compared to EBL.Conclusion Cap-assisted endoscopic resection is not a safe method for resection of small gastric SMT with high risk and should be carefully considered in clinical practice.