内镜下黏膜剥离治疗上消化道黏膜下肿瘤疗效观察

目的探讨内镜下黏膜剥离治疗上消化道黏膜下肿瘤的效果、安全性和并发症等。方法经内镜检查发现上消化道黏膜下肿瘤病人38例（共39个病灶）,内镜下用圈套器剥离肿瘤顶部的黏膜,暴露出部分肿瘤,用钩刀、针刀或绝缘刀分离肿瘤的周围组织,再从肿瘤的底部分离。结果 38例病人（39个病灶）全部一次性切除成功,切除率为100%,手术时间为20-125min,手术中及手术后无出血、穿孔、食管狭窄等并发症。病理结果：平滑肌瘤30例、脂肪瘤5例及间质瘤3例。手术后3个月复查内镜均无复发。结论内镜下黏膜剥离治疗上消道黏膜下肿瘤是一种安全、有效、创伤小的治疗方法。

Endoscopic submucosal dissection for treating upper gastrointestinal submucosal tumors

Objective To evaluate the effects,safety and complications of endoscopic submucosal dissection,which was used for treating upper gastrointestinal submucosal tumors.Methods 38 patients was diagnosed upper gastrointestinal submucosal tumors by endoscopy（39 lesions）.The mucosa at the top of the tumor was stripped by endoscopic with snare that exposing part of the tumor,we separated the surrounding tissue of the tumor by hook knife and acusector or insulation knife,and separated the bottom of the tumor. Results 39 lesions in 38 patients were all one-time excised successfully,and removal rate was 100%. Operation time was 20-125 minutes,No complications such as hemorrhage,perforation,esophageal stricture,appeared in the surgery and postoperation. Pathological results：eiomypma in 30 cases,lipoma in 5 cases,ectopic pancreas in 8 cases and stomal tumors in 3 cases. No recurrence was found after operation.Conclusion Endoscopic submucosal dissection is a safe,effective,minimally invasive technique for the treatment of upper gastrointestinal submucosal tumors.