STER治疗食道及胃食管结合部固有肌层肿瘤的疗效观察

Observation of the curative effect of STER in the treatment of muscularis propria tumors of esophagus and gastroesophageal junction

目的:探讨内镜经黏膜下隧道肿瘤切除术(submocosal tunnel endoscopic resection,STER)治疗食道及胃食管结合部固有肌层肿瘤的临床效果和安全性。方法:回顾性分析行STER治疗的12例食管及胃食管结合部固有肌层肿瘤患者的临床资料,评价治疗的可行性、安全性和疗效。结果:12例食管及胃食管结合部固有肌层肿瘤患者行STER治疗,1次性完整切除12例,成功率为100%(12/12)。切除瘤体直径1.0~4.3 cm,平均直径(2.58±1.89)cm,手术时间45~120 min,平均手术时间(87.25±46.23)min。术后并发皮下气肿3例(25%),无气胸及纵膈气肿,均经保守治疗后痊愈,无迟发性出血、食管瘘、纵隔感染等并发症发生。STER术后病理示平滑肌瘤10例,间质瘤2例。术后所有患者随访3~12个月,未发现肿瘤复发。结论:STER技术治疗食管及胃食管结合部固有肌层肿瘤安全可靠。

Objective:To investigate the clinical efficacy and safety of submocosal tunnel endoscopic resection(STER)for esophagus and gastroesophageal junction muscularis propria.Methods:Clinical data of 12 patients with esophageal and gastroesophageal junction muscularis propria tumors treated with STER were retrospectively analyzed to evaluate the feasibility,safety and efficacy of the treatment.Results:Twelve patients with esophagus and gastroesophageal junction muscularis propria tumors received STER treatment.Twelve patients underwent one complete resection,with a success rate of 100%(12/12).The resected tumor diameter ranged from 1.0 cm to 4.0 cm,with an average diameter of(2.58±1.89)cm.The operative time ranged from 45 min to 120 min,with an average operative time of(87.25±46.23)min.Postoperative subcutaneous emphysema occurred in 3 cases(25%)without pneumothorax or mediastinal emphysema.All cases were cured after conservative treatment,and no complications such as delayed hemorrhage,esophageal fistula or mediastinal infection occurred.Postoperative pathology of STER showed leiomyoma in 10 cases and stromal tumor in 2 cases.All patients was followed for3-12 months,and no tumor recurrence was found.Conclusion:The STER technique is safe and reliable in the treatment of esophageal and gastroesophageal junction muscularis propria tumors.