内镜经黏膜下隧道肿瘤切除术治疗上消化道多发黏膜下肿瘤的疗效及安全性评价
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1.台州市立医院消化内科;2.上海市东方医院

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浙江省中医药科技计划项目(2022ZB393)


Efficacy and safety of submucosal tunneling endoscopic resection for multiple submucosal tumors of upper gastrointestinal tract
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Traditional Chinese Medicine Science and Technology Plan of Zhejiang Province (2022ZB393)

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    摘要:

    为了评估内镜经黏膜下隧道肿瘤切除术(submucosal tunneling endoscopic resection,STER)治疗上消化道多发黏膜下肿瘤(submucosal tumors,SMT)的疗效和安全性,收集了2016年1月至2021年6月就诊于台州市立医院以及上海东方医院的总计24例上消化道SMT病例(共56个SMT病灶)纳入回顾性观察,主要分析治疗效果、主要不良事件发生情况和随访结果。结果显示:19例(79.2%)通过一条隧道切除肿瘤,5例(20.8%)通过两条隧道切除肿瘤;隧道长度3~12 cm,平均6.2 cm;手术时间19~130 min,平均55.6 min;肿瘤整块切除率为89.29%(50/56);住院时间2~7 d,平均3.5 d;2例(8.3%)发生主要不良事件,均为黏膜损伤,用钛夹和自膨胀金属封闭支架治愈;随访6~64个月,平均32.0个月,随访期间无肿瘤残留或植入隧道,无局部复发和远处转移,无死亡病例。由此可见,STER治疗上消化道多发SMT安全可行,切除方法以单隧道为主要,但对于相距较远的多个SMT则需要双隧道方法治疗。

    Abstract:

    In order to evaluate the efficacy and safety of submucosal tunneling endoscopic resection (STER) for the treatment of multiple submucosal tumors (SMT) in the upper gastrointestinal tract, data of 24 cases with upper gastrointestinal SMT (including 56 SMT lesions) treated at Taizhou Municipal Hospital and Shanghai East Hospital from January 2016 to June 2021 were collected for retrospective observation. The treatment effect, occurrence of major adverse events and follow-up results were analyzed. The results showed that 19 cases (79.2%) underwent tumor resection through one tunnel, and 5 cases (20.8%) underwent tumor resection through two tunnels. The length of the tunnel was 3-12 cm, with an average of 6.2 cm. The surgical time ranged from 19 to 130 minutes, with an average of 55.6 minutes. The overall resection rate was 89.29% (50/56). The hospitalization time was 2-7 days, with an average of 3.5 days. Major adverse events occurred in 2 cases (8.3%), all of which were mucosal injuries, and were cured with titanium clips and self expanding metal sealing stents. During a follow-up period of 6-64 months, with an average of 32.0 months, there was no residual tumor, tumor implantation tunnel, local recurrence, distant metastasis or death. To sum up, STER is safe and feasible for the treatment of multiple SMT in the upper gastrointestinal tract. The main resection method is single tunnel, and double tunnel is required for multiple SMT far apart.

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王国祥,余光,项艳丽,等.内镜经黏膜下隧道肿瘤切除术治疗上消化道多发黏膜下肿瘤的疗效及安全性评价[J].中华消化内镜杂志,2023,40(6):478-480.

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  • 收稿日期:2022-09-11
  • 最后修改日期:2023-06-06
  • 录用日期:2022-10-19
  • 在线发布日期: 2023-06-26
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