内镜粘膜切除术联合橡皮胶圈套扎治疗食管平滑肌瘤

目的探讨内镜粘膜切除术联合橡皮胶圈套扎（EMR-L）治疗食管平滑肌瘤的效果及安全性。方法 18例上消化内镜发现食管粘膜下隆起病变的患者接受超声内镜检查确诊病变源于粘膜肌层,确定无手术禁忌后,进行EMR-L切除病变。病变标本送病理检查。结果 18例患者顺利完成EMR-L切除病变,耗时20～45分钟,平均为（25±4.7）分钟。病理检查结果均为食管平滑肌瘤。2例患者发生急性出血,予药物喷洒、电凝或钛夹钳夹等治疗后出血停止。无急性或延迟性食管穿孔及食管管腔狭窄等并发症出现。结论 EMR-L可有效、安全地切除食管粘膜肌层的平滑肌瘤,有较好的临床应用价值。

Endoscopic mucosal resection with ligation in treatment of esophageal leiomyoma

Objective To research the effect and safety of endoscopic mucosal resection with ligation（EMR-L） on esophageal leiomyoma.Methods Under upergastric endoscopy,18 patients were found esophageal submucosal protrusive lesions,which were proved to originate from the muscularis mucosa by ultrasonic endoscopy.The patients without contraindications underwent EMR-L for therapy of lesions.The specimens were sent to pathological examinations.Results All lesions were resected by EMR-L.The time-consuming was in a range of 20-45 minutes（the average was 25±4.7 minutes）.The pathologic results were esophageal leiomyoma.Acute bleeding occurred in 2 patients.The bleeding could be controlled with several methods（drugs,electric coagation or titanium clips）.No esophageal acute or delay perforation and stricture occurred.Conclusion EMR-L is effective and safe in treatment of esophageal leiomyoma which originate from the muscularis mucosa.