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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. 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. 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:
引用本文:

王晓松, 朱季军, 王玉欣, 刘云云, 王晓燕. 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[J]. 中华临床医师杂志(电子版), 2020, 14(01): 18-21.

Xiaosong Wang, Jijun Zhu, Yuxing Wang, Yunyun Liu, Xiaoyan Wang. Endoscopic submucosal tunnel tumor resection for benign submucosal tumors of the cervical esophagus: Strategies and complications[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(01): 18-21.

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。

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.

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
1
Ye LP, Zhang Y, Mao XL, et al. Submucosal tunneling endoscopic resection for the treatment of esophageal submucosal tumors originating from the muscularis propria layer: An analysis of 15 cases [J]. Dig Liver Dis, 2013, 45(2): 119-123.
2
尚保敏,王红建. 内镜下黏膜切除术治疗食管平滑肌瘤42例的临床观察[J].胃肠病学和肝病学杂志, 2013, 22(8): 752-754.
3
马春艳.消化道黏膜下肿瘤内镜微创切除新技术的应用价值[J].河北医学, 2014, 20(4): 633-635.
4
Se Kumbhari V, Saxena P, Azola A, et al. Submucosal tunneling endoscopic resection of a giant esophageal leiomyoma [J]. Gastrointest Endosc, 2015, 81(1): 219-220.
5
Meng FS, Zhang ZH, Hong YY, et al. Comparison of endoscopic submucosal dissection and surgery for the treatment of gastric submucosal tumors originating from the muscularis propria layer: a single-center study (with video) [J]. Surg Endosc, 2016, 30(11): 5099-5107.
6
李清峰,岳辉,何锋坚,等. 内镜隧道黏膜下肿瘤切除术治疗来源于食管固有肌层黏膜下肿瘤的价值研究[J].中华临床医师杂志(电子版), 2014, 8(8): 1502-1506.
7
Inoue H, Ikeda H, Hosoya T, et al. Submucosal endoscopic tumor resection for subepithelial tumors in the esophagus and cardia [J].Endoscopy, 2012, 44(3): 225-230.
8
Ye LP, Zhang Y, Mao XL, et al. Submucosal tunneling endoscopic resection for small upper gastrointestinal subepithelial tumors originating from the muscularis propria layer [J]. Surg Endosc, 2014, 28(2): 524-530.
9
Wang L, Ren W, Zhang Z, et al. Retrospective study of endoscopic submucosal tunnel dissection (ESTD) for surgical resection of esophageal leiomyoma [J]. Surg Endoscopic, 2013, 27(11): 4259-4266.
10
姚礼庆,徐美东,马丽黎等. 实用消化内镜手术学[M]. 武汉: 华中科技大学出版社, 2013: 404-409.
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