内镜套扎切除术和内镜黏膜下挖除术治疗固有肌层起源小胃肠间质瘤的疗效分析
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中国人民解放军联勤保障部队第九〇九医院(厦门大学附属东南医院)消化内科

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漳州市自然科学基金(ZZ2021J25);福建省自然科学基金面上项目(2021J01545);军事医学创新专项(20YJ002)


Efficacy of endoscopic ligation resection and endoscopic submucosal excavation for small gastrointestinal stromal tumors originating from muscularis propria
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Department of gastroenterology, The 909th Hospital of Joint Logistics Support Force of PLA (also The Affiliated Southeast Hospital of Xiamen University)

Fund Project:

Natural Science Foundation of Zhangzhou (ZZ2021J25); General Program of Natural Science Foundation of Fujian Province (2021J01545); Innovation Special Program of Military Medicine (20YJ002)

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    摘要:

    本研究采集2016年1月—2018年12月在中国人民解放军联勤保障部队第九〇九医院消化内镜中心经内镜治疗的长径≤1.2 cm胃肠间质瘤(gastrointestinal stromal tumor,GIST)病例43例,按术式分为内镜套扎切除术(endoscopic ligation resection,ELR)组27例和内镜黏膜下挖除术(endoscopic submucosal excavation,ESE)组16例,比较两组患者的一般资料、围手术期资料和随访资料。结果显示,两组患者的一般资料差异无统计学意义,具有可比性。手术时间,ELR组20.0(18.0,25.0) min,ESE组27.5(23.0,37.5) min,组间比较差异有统计学意义(U=92.5,P=0.001)。整块切除率,ELR组100.0%(27/27),ESE组81.3%(13/16),组间比较差异有统计学意义(P=0.045)。术后住院时间,ELR组3(2,4) d,ESE组5(4,6) d,组间比较差异有统计学意义(U=125.5,P=0.020)。两组的术中出血率和出血量、术中穿孔率,止血夹数量以及术后出血、发热、腹膜炎等并发症发生情况,差异均无统计学意义(P>0.05)。两组随访均未见间质瘤复发和转移。可见对于病变长径≤1.2 cm的小GIST,ELR和ESE均可安全有效切除,ELR手术时间、术后住院时间更短,整块切除率更高。

    Abstract:

    Clinical data of 43 patients who underwent endoscopic resection for gastrointestinal stromal tumors (GIST) of length ≤1.2 cm at the Digestive Endoscopy Center of the 909th Hospital from January 2016 to December 2018 were retrospectively analyzed. The patients were divided into the endoscopic ligation resection (ELR) group (n=27) and the endoscopic submucosal excavation (ESE) group (n=16). The general, perioperative and follow‑up data of the two groups were compared. The results showed that there was no significant difference in the general data between the two groups. The operation time was 20.0 (18.0,25.0) min in the ELR group and 27.5 (23.0,37.5) min in the ESE group, showing significant difference (U=92.5, P=0.001). The en bloc resection rates were 100.0% (27/27) in the ELR group and 81.3% (13/16) in the ESE group, showing significant difference (P=0.045). The postoperative hospital stays were 3 (2,4) days in the ELR group and 5 (4,6) days in the ESE group, showing significant difference (U=125.5, P=0.020). There was no significant difference in the intraoperative bleeding rate, intraoperative hemorrhage volume, intraoperative perforation rate, number of hemostatic clips or postoperative complications including hemorrhage, fever and peritonitis between the two groups (P>0.05). During the follow‑up, there was no recurrence or metastasis of GIST in both groups. ELR and ESE can be safe and effective for small GIST ≤1.2 cm in diameter. Compared with the ESE group, the operation time and postoperative hospital stay are shorter with higher en bloc resection rate in the ELR group.

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温春虹,刘将,唐庆林,等.内镜套扎切除术和内镜黏膜下挖除术治疗固有肌层起源小胃肠间质瘤的疗效分析[J].中华消化内镜杂志,2022,39(11):921-924.

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  • 收稿日期:2021-04-28
  • 最后修改日期:2022-09-15
  • 录用日期:2021-12-20
  • 在线发布日期: 2022-09-16
  • 出版日期: 2022-11-20
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