食管平滑肌瘤的诊断与治疗

目的 总结10年来食管平滑肌瘤诊断与治疗的经验。方法 分析1993年至2002年间52例食管平滑肌瘤患者的临床资料。结果 本组54％的患者以进食困难为首发症状。诊断准确率：上消化道钡剂低张双对比造影检查为64％，CT为44％，胃镜为27％，超声内镜为90％。本组患者经胸腔镜手术6例，内镜下切除术9例，行食管平滑肌瘤摘除术32例，食管部分切除、食管胃吻合术5例。仅1例术后出血，经再次手术止血；其余未发生严重的术后并发症。结论 超声内镜是诊断食管平滑肌瘤的有效手段，对于适合的病例要积极考虑胸腔镜手术及内镜摘除以减轻创伤。

Diagnosis and treatment of esophageal leiomyoma

Objective To summarize the experience of diagnosis and treatment of esophageal leiomyoma. Methods Clinical data of 52 patients with esophageal leiomyoma were analyzed from 1993 to 2002. Results About 54%patients in this group had difficulty of food intake. The diagnostic accuracy of gastrointestinal barium meal series,computed tomography,gastric endoscope and endoscopic ultrasonography(EUS) for esophageal leiomyoma was 64%,44%,27%and 90%,respectively. All patients received operation,resection of esophageal leiomyoma by videothoracoscope(VAS) and endoscope were performed in 6,9 patients respectively; The remaining 37 patients received regular open operation,in whom 32 cases received enucleation of esophageal leiomyoma,5 cases received partial esophageal resection and esophageal gastric anastomosis. No serious complications occured except only one case needed operation again because of bleeding. Conclusion EUS is an effective method for diagnosing esophageal leiomyoma. VAS and endoscopic treatment should be considered for suitable cases in order to reduce the trauma.