摘要
目的通过对比经黏膜下隧道内镜切除术(submucosal tunnelingendoscopicresection,STER)与其他治疗方式在治疗食管固有肌层平滑肌瘤的结果差异,探讨STER的安全性及适应症.方法回顾2012-11-01/2018-03-01期间,因食管固有肌层平滑肌瘤行切除治疗的121名患者,收集并分析其临床特点及治疗结果.结果胸腔镜切除(thoracoscopic enucleation, TE)组与内镜切除(endoscopic resection, ER)组在肿瘤的生长部位和大小、手术时间、整块切除率、患者平均住院日和平均住院费用方面的差异具有统计学意义(P<0.05);STER组与TE组在整块切除率、手术时间、患者平均住院日和费用方面的差异具有统计学意义(P<0.05),尽管STER组肿瘤直径(2-40 mm,平均17.68mm)比TE组肿瘤直径(5-80 mm,平均20.33 mm)小,但差异并无统计学意义(P=0.229);而STER组与内镜黏膜下剥离术(endoscopic submucosal dissection, ESD)组的对比中发现,两组在肿瘤直径、整块切除率和患者住院费用方面的差异具有统计学意义(P<0.05).尽管研究过程中我们发现STER组的整块切除率低于外科组和ESD组,但平均随访22.4 mo(3-60 mo),三个组均未见肿瘤复发及转移.结论 STER是一种安全、有效的内镜下治疗手段,对于≤4cm的食管固有肌层平滑肌瘤,我们推荐优先考虑STER切除.
AIM To investigate the safety and indications of submucosal tunneling endoscopic resection（STER） by comparing the results of STER with other operations for the treatment of esophageal leiomyomas originating from the muscularis propria layer.METHODS We enrolled 121 patients with esophageal leiomyomas originating from the muscularis propria layer who underwent resection from November 1, 2011 to March 1, 2018 in this retrospective study. The clinical features and treatment results were collected and analyzed. RESULTS There was a significant difference between the thoracoscopic enucleation（TE） group and the endoscopic resection（ER） group in tumor location and size, operation time, en bolc resection rate, average hospital stay and cost（P〈0.05）. There was also a significant difference in the en bolc resection rate, operative time, average hospital stay and cost between the STER group and the ER group（P〈0.05）. Although tumor diameter of the STER group（2-40 mm; mean, 17.68 mm） was smaller than that of the TE group（5-80 mm; mean, 20.33 mm）, the difference was not significant（P = 0.229）. Tumor size, en bolc resection rate, average hospital stay and cost also differed significantly between the STER group and the endoscopic submucosal dissection（ESD） group（P〈0.05）. The en bolc resection rate of the STER group was lower than those of other groups, but no tumor recurrence or metastasis was detected during the follow-up period（mean： 22.4 mo; range： 3-60 mo） in the three groups.CONCLUSION STER is safe and effective for the treatment of esophageal leiomyomas originating from the muscularis propria layer. We recommend STER for the tumors smaller than 4 cm.
作者
张明月
吴双
郭秀颖
徐红
Ming-Yue Zhang;Shuang Wu;Xiu-Ying Guo;Hong Xu(Department of Gastroenterology,the First Hospital of Jilin University,Changchun 131000,Jilin Province,China;Department of Gastroenterology,the Hospital of Kuancheng District,Changchun 131000,Jilin Province,China)
出处
《世界华人消化杂志》
CAS
2018年第28期1660-1666,共7页
World Chinese Journal of Digestology
