内镜经黏膜下隧道肿瘤切除术治疗颈部食管黏膜下良性肿瘤策略和并发症分析

doi:10.3877/cma.j.issn.1674-0785.2020.01.004

中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 18 -21. doi: 10.3877/cma.j.issn.1674-0785.2020.01.004

所属专题：文献；

临床研究

内镜经黏膜下隧道肿瘤切除术治疗颈部食管黏膜下良性肿瘤策略和并发症分析

王晓松¹, 朱季军¹, 王玉欣¹, 刘云云¹, 王晓燕¹^,^†(

)

^1. 223800　宿迁市第一人民医院消化内科

收稿日期:2019-10-11 出版日期:2020-01-15
通信作者: 王晓燕
基金资助:
宿迁市重点研发计划(社会发展S201724); 宿迁市科技支撑计划项目(S201629)

Endoscopic submucosal tunnel tumor resection for benign submucosal tumors of the cervical esophagus: Strategies and complications

Xiaosong Wang¹, Jijun Zhu¹, Yuxing Wang¹, Yunyun Liu¹, Xiaoyan Wang¹^,^†()

^1. Department of Gastroenterology, the No.1 People′s Hospital of Suqian, Suqian 223800, China

Received:2019-10-11 Published:2020-01-15
Corresponding author: Xiaoyan Wang
About author:
Corresponding author: Wang Xiaoyan, Email: 726343819@qq.com

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目的

评估内镜经黏膜下隧道肿瘤切除术(STER)治疗颈部食管黏膜下肿瘤的可行性及安全性。

方法

收集2017年1月至2018年1月本院收治的12例颈部食管黏膜下良性肿瘤并接受STER治疗的患者资料，分析其整块切除率、治愈性切除率、手术及住院时间、术后相关并发症。

结果

12例颈部食管黏膜下肿瘤均行STER治疗，男7例，女5例，年龄（58.3±11.6）岁，病灶距门齿（19.41±0.51）cm，切除瘤体直径（16.25±6.44）mm，手术时间为（45.00±?.??）min，整块切除率91.67%（11/12），治愈性切除率100%（12/12）。术中出血1例（8.33%，1/12），无穿孔，术后有8例（66.67%，8/12）出现不同程度发热，有9例（75.00%，9/12）出现咽喉部不适或胸骨后烧灼不适，住院时间为（8.17±1.11）d，术后随访未发现病变残留、复发及食管狭窄。

结论

STER治疗颈部食管黏膜下良性肿瘤是安全有效的治疗方法。

关键词: 黏膜下隧道肿瘤切除术, 内镜, 颈部食管黏膜下良性肿瘤, 并发症

Objective

To evaluate the feasibility and safety of endoscopic submucosal tunnel tumor resection for benign submucosal tumors of the cervical esophagus.

Methods

Twelve patients undergoing endoscopic submucosal tunnel resection for cervical esophageal submucosal tumors from January 2017 to January 2018 at our hospital were collected, and the en bloc resection rate, curative resection rate, hospital stay, and related complications were analyzed.

Results

All the 12 patients with cervical esophageal submucosal tumors underwent endoscopic submucosal tunnel tumor resection, including 7 males and 5 females. Their mean age was (58.3±11.6) years, the average distance from the incisors was (19.41±0.51) cm, the diameter of resected tumors was (16.25±6.44) mm, and the operating time was (45.00±6.57) min. The en bloc resection rate was 91.67% (11/12), and the curative resection rate was 100% (12/12). There was no perforation during the operation, but one case had intraoperative bleeding. Fever occurred in 8 (66.67%) cases after operation, and throat discomfort or post-breast bone burning sensation developed in 9 (75.00%) cases. The mean hospital stay was (8.17±1.11) days. No residual lesions, recurrence, or esophageal stricture were found during follow-up.

Conclusion

Endoscopic submucosal tunnel tumor resection can be used as a safe and effective method for benign submucosal tumors of the cervical esophagus.

Key words: Submucosal tunnel resection, Endoscope, Benign submucosal tumors of the cervical esophagus, Complications

图2 超声内镜下观察食管隆起性病变

图3 STER手术操作过程　图a为建立黏膜下隧道，并剥离病灶；图b为切除病灶；图c为钛夹夹闭隧道入口；图d为取出的手术标本

图4 术后病理：图a为平滑肌瘤；图b为囊肿；图c为间质瘤

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