内镜黏膜下剥离术治疗胃底固有肌层肿瘤18例临床分析

目的探讨内镜黏膜下剥离术(ESD)治疗胃底固有肌层肿瘤的疗效和安全性。方法对胃镜及超声胃镜检查发现的来源于胃底固有肌层的肿瘤应用IT刀、HOOK刀进行ESD治疗。结果 18例来源于胃底固有肌层的肿瘤全部完整剥离,所有剥离病变全部得到病理确诊,基底和切缘未见病变累及。术中出血量平均40ml,均经电凝、氩离子血浆凝固和止血夹成功止血,ESD穿孔发生率17%(3/18)。结论 ESD是治疗胃底固有肌层肿瘤的有效方法,疗效可靠,不仅可以完整切除病变,还能提供完整的病理学诊断资料。

Clinical Study of ESD in the Treatment of 18 Cases with Muscularis Propria Tumor in Stomach Fundus

Objective To study the curative effect and the safey of ESD in the treatment of muscularis propria tumor in stomach fundus. Methods IT knife and HOOK knife were applied in the ESD treatment of muscularis propria tumor in stomach fundus revealed in the examinations of gastroendoscope and ultrasound gastroendoscope. Result The muscularis propria tumors in stomach fundus of 18 cases were wholly removed and were final-diagnosed by pathological study;there were no pathological involvement in the base or along the incision edge;the average amount of bleeding in the operation was 40ml and the bleeding was successfully stopped with electro-coagulation,argon plasma coagulation or metal clips;the the performation rate was 17%（3/18）. Conclusions The ESD treatment for muscularis propria tumor in stomach fundus is of reliable curative effect as it can not only wholly remove the lesions but also provide pathological proves for reference.