隧道技术治疗食管中下段隆起性病变24例的临床研究

发布时间：2018-06-04 04:50

本文选题：隧道技术 + 内镜下经隧道黏膜剥离治疗　；参考：《中国内镜杂志》2016年03期

【摘要】：目的研究通过隧道技术治疗24例食管中下段隆起性病变的可行性、安全性及疗效。方法 24例患者中,男7例,女17例,年龄40~69岁,平均(51.75±9.19)岁。常规给予超声内镜检查,使用常规内镜下黏膜剥离术(ESD)与材料,在距离食管隆起性病变近端5.0 cm处开口,建立隧道直达病灶,对病灶进行剥离,记录切口方向、病变位置、病变起源、剥离的时间、肿物的大小、病理类型及并发症情况。术后放置胃肠减压管,分别于术后1、3、6及12个月复查胃镜。结果超声内镜显示有6例起源于黏膜下层,18例起源于固有肌层。24例患者病灶直径为0.6~3.5 cm,平均大小(1.34±0.64)cm,切除时间为30~100 min,平均52.42 min,病灶均完整切除,术后有3例出现纵膈、腹腔、皮下气肿,1周后自行吸收,未见明显穿孔,余患者均未出现严重出血、穿孔等并发症。术后1、3、6及12个月复查胃镜,均未见复发。结论隧道技术治疗食管中下段隆起性病变是安全有效的。
[Abstract]:Objective to study the feasibility, safety and efficacy of tunnel technique in the treatment of 24 cases of middle and lower esophageal protruding lesions. Methods 24 patients, 7 males and 17 females, aged 4069 years (mean 51.75 卤9.19) years old. Conventional endoscopic ultrasonography was performed, and ESD) and materials were used to establish a tunnel through which the lesion was directly removed from the proximal end of the esophageal protuberant lesion, and the direction of the incision and the location of the lesion were recorded. The origin of the lesion, the time of exfoliation, the size of the tumor, the pathological type, and the complications. Gastrointestinal decompression tube was placed after operation. Gastroscopy was performed at 1: 3 and 12 months postoperatively. Results EUS showed that 6 cases originated from submucous layer and 18 cases originated from muscularis propria. 24 cases had lesion diameter of 0.610 ~ 3.5 cm, mean size of 1.34 卤0.64 cm, resection time was 30 ~ 100 min (mean 52.42 min), all lesions were removed completely, 3 cases appeared mediastinum and abdominal cavity after operation. After 1 week of subcutaneous emphysema, there was no obvious perforation, no severe bleeding, perforation and other complications. No recurrence was found under gastroscopy at 1: 3 and 12 months after operation. Conclusion Tunnel technique is safe and effective in the treatment of middle and lower esophageal protruding lesions.
【作者单位】：新乡医学院第一附属医院消化内科;新乡医学院第一附属医院皮肤科;新乡医学院第一附属医院研究生院;新乡医学院第一附属医院普外科;新乡医学院第一附属医院麻醉科;
【基金】：新乡医学院科研培育基金(No:2013QN128)
【分类号】：R655.4

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