内镜下橡皮圈套扎术治疗上消化道黏膜下肿瘤疗效观察——附46例报告

目的：探讨内镜下橡皮圈套扎术治疗上消化道黏膜下肿瘤的适应证、近期疗效及并发症。方法：选取经普通胃镜及超声内镜检查，诊断为食管、胃及十二指肠黏膜下肿瘤的病例，均拟诊为上消化道间质瘤或平滑肌瘤，病灶≤1．2cm，呈内向型生长。所有病变均采用橡皮圈套扎术治疗，术后常规口服PPI并于术后2周复查胃镜。结果：共46例患者，肿瘤均为单发，直径0．5～1．2cm，平均（0．9±0．2）cm。病变位于食管19例（41％）、胃20例（44％）、十二指肠7例（15％）；位于固有肌层24例（52％）、黏膜肌层22例（48％）。45例完成套扎，1例因不能耐受手术中途放弃套扎。术后2周复查胃镜显示43例病变完全脱落，1例部分脱落，病变变小，1例胃底穿孔未复查胃镜。1例术后5d内出现一过性少量黑便，1例术后第1天出现胃底穿孔。治愈率为94％（43／46），并发症发生率为4％（2／46）。结论：内镜橡皮圈套扎术治疗符合适应证的上消化道黏膜下肿瘤，安全有效，操作简便易行。

Efficiency of endoscopic ligation in treating upper gastrointestinal submucosal tumors

Objective： To evaluate the safety and efficiency of endoscopic elastic band ligation in treating upper gastrointestinal submucosal tumors （SMTs）. Methods： Forty-six patients with, which were diagnosed as gastrointestinal stromal tumors or leiomyomas by endoscopy and endoscopic uhrasonography （EUS）, were enrolled. The procedure of endoscopic elastic band ligation was performed on each of the patients enrolled. After that, all patients received PPI treatment for 2 weeks and then endoscopic follow-up examinations. Results： Of all 46 patients , the diameters of lesions ranged 0. 5 - 1.2 cm, （0. 9 ±0. 2） cm average. Nineteen cases located in esophagus （41 % ）, 20 in stomach （44 % ）, 7 in duodenal （ 15 % ）, 24 in muscularis propria （52 % ） and 22 in muscularis mucosae （48 % ）, respectively. 45 patients （98 % ） undergone endoscopic elastic band ligation successfully, while 1 patient （2 % ） quitted because of intolerance. Results of the endoscopic follow-up examniation after 2 weeks showed that lesions were completely detached in 43 patients, only 1 resection was incomplete. Besides, transient bleeding occurred in 1 patient in 5 days after ligation and disappeared without special management. Gastric perforation occurred in another patient who was successfully treated by surgery. The total healing rate was 94 % （43/46） and the complication rate was 4% （2/46） Conclusion： Endoscopic elastic band ligation is an efficient, safe and easy modality for treating submucosal tumors in upper gastrointestinal tract.