“悬吊法”在胃底固有肌层肿瘤内镜全层切除术中的应用

背景随着内镜技术的发展,对于起源于固有肌层的胃黏膜下肿瘤(submucosal tumor,SMT)临床医师常采用内镜全层切除术(endoscopic full-thickness resection,EFTR)切除;然而对于胃底黏膜下肿瘤应用传统方法有诸多缺点,应用悬吊法辅助EFTR可解决传统方法的弊端,对其效果及安全性的临床研究尚不多.目的探讨“悬吊法”在胃底固有肌层肿瘤内镜全层切除术中的应用价值.方法回顾性分析天津市第五中心医院消化内科2017-08/2021-06期间22例胃底固有肌层肿瘤的患者接受EFTR的临床资料.按不同手术方式分为传统EFTR组和改良“悬吊法”+EFTR组.对照组12例患者进行传统EFTR,观察组10例患者进行改良“悬吊法”+EFTR.比较两组方法的手术时间、术中出血量、创面缝合时间、住院时间.结果观察组比对照组患者手术时间、创面缝合时间短,术中出血量少,两组间具有统计学差异(P<0.05).结论“悬吊法”+EFTR可更好地缩短手术时间及创面缝合时间,降低术中出血量,对于治疗胃底固有肌层肿瘤是一种安全的、可行的、有效的方法,适合在临床应用.

Clinical application of“suspension method”in endoscopic full-thickness resection for muscularis propria tumors of the gastric fundus

BACKGROUND With the development of endoscopic technology,clinicians often use endoscopic full-thickness resection(EFTR)for the treatment of gastric muscularis propria tumors,but traditional methods have many disadvantages for gastric fundus submucosal tumors.Using suspension method to assist EFTR can solve the disadvantages of traditional methods,but there are few clinical studies on its efficacy and safety.AIM To investigate the clinical value of“suspension method”in EFTR for muscularis propria tumors of the gastric fundus.METHODS A retrospective analysis was performed on the clinical data of 22 patients with muscularis propria tumors in the gastric fundus who underwent EFTR at the Gastroenterology Department of Tianjin Fifth Central Hospital from August 2017 to June 2021.According to the surgical method used,the patients were divided into a traditional EFTR group and a modified“suspension method”+EFTR group.Operative time,intraoperative bleeding,wound suture time,and hospital stay were compared between the two groups.RESULTS The operative time,intraoperative bleeding,and wound suture time in the modified“suspension method”+EFTR group were significantly lower than those in the traditional EFTR group(P<0.05).CONCLUSION“Suspension method”combined with EFTR can shorten the operation time and wound suture time,and decrease the intraoperative bleeding.It is a safe,feasible,and effective method for the treatment of muscularis propria tumors of the gastric fundus,and is suitable for clinical application.