内镜下隧道技术切除食管肌层来源粘膜下肿瘤可行性研究

发布时间：2018-06-25 16:31

本文选题：内镜下黏膜剥离术 + 黏膜下隧道　；参考：《吉林大学》2016年硕士论文

【摘要】：背景:食管壁不同层次可以发生不同种类的良性肿瘤。此类肿瘤通常不引起症状,并且生长缓慢,常常由体检是行食管影像学检查或者内镜检查发现。最常见的食管良性肿瘤是平滑肌瘤。内镜下治疗方式逐步发胀,从简单的活检病理到应用圈套器直接切除,再到内镜下黏膜切除术(EMR)。目前研究发现EMR仍存在一定局限性,例如肿瘤残留及肿瘤再发。目前,几项研究表明内镜下黏膜下隧道技术可以应用于上皮下肿瘤治疗。内镜下黏膜下隧道切除术(STER)可以安全有效的切除起源于上消化道固有肌层肿物(MP)。目的:本研究目的在于评价内镜下隧道技术治疗食管固有肌层肿物的临床价值,对比食管固有肌层肿物和胃内固有肌层肿物治疗中的异同。类型单中心回顾性研究。研究单位及时间吉林长春吉林大学第一医院内镜中心,2014年1月-2016年1月。方法:对比研究22名上消化道固有肌层来源SMT患者应用STER技术治疗效果。结果:患者平均年龄是52.32岁(35-68岁)。男女比例为1:1.完整切除率为82%。18处病变整块切除。病理结果为平滑肌瘤(10/22)和间质瘤(9/22)。结论:STER治疗SMT的整块切除率和完整切除率较高,应用软式内镜治疗消化道黏膜下肿瘤技术可以广泛推广。内镜下隧道技术治疗胃内黏膜下肿瘤难度较食管内黏膜下肿瘤的难度高,但是在胃内进行隧道治疗并不增加手术相关不良事件。隧道技术治疗消化道黏膜下肿瘤具有较高的一块切除率,在软式内镜下进行,此项技术被广泛接受。STER作为新的内镜下切除技术治疗食管固有肌层起源的肿瘤是可行的、安全的、有效的方法。应用STER技术切除食管固有肌层起源肿瘤可以完好保存食管黏膜层,可以减少全层切除伴有的感染等其他并发症。
[Abstract]:Background: various types of benign tumors may occur at different levels of the esophageal wall. These tumors are usually asymptomatic and slow to grow, often detected by a physical examination of esophagus imaging or endoscopy. The most common benign tumor of the esophagus is leiomyoma. Endoscopic dilatation, from simple biopsy and pathology to direct resection with trap, to endoscopic mucosal resection (EMR). Current studies have found that EMR still has some limitations, such as tumor residues and tumor recurrence. Currently, several studies have shown that endoscopic submucosal tunneling can be used in the treatment of subepithelial tumors. Endoscopic submucosal tunnel resection (star) can be performed safely and effectively from the superior digestive tract propria myomegaly (MP). Objective: to evaluate the clinical value of endoscopic tunnel technique in the treatment of esophageal muscular lamina propria. Type single center retrospective study. Research Unit and time Endoscopic Center, first Hospital of Jilin University, Changchun, Jilin Province, January 2014-January 2016. Methods: 22 patients with SMT derived from the superior digestive tract were studied. Results: the average age of the patients was 52.32 years (35-68 years). The ratio of men to women is 1: 1. The complete resection rate was 82.18 lesions. Pathological findings were leiomyoma (10 / 22) and stromal tumors (9 / 22). Conclusion the mass resection rate and complete resection rate of SMT treated by weight ster are higher. The soft endoscopy can be widely used in the treatment of submucosal tumors of digestive tract. Endoscopic tunneling is more difficult to treat submucous tumor in stomach than that of submucous tumor in esophagus, but tunneling in stomach does not increase the adverse events associated with operation. The tunneling technique for the treatment of submucosal tumors of digestive tract has a high removal rate and is performed under soft endoscopy. This technique is widely accepted as a new endoscopic resection technique for the treatment of neoplasms originating from the lamina propria muscularis of the esophagus, which is feasible and safe. An effective method. The resection of the origin tumor of the lamina propria muscularis of the esophagus by the technique of fer can preserve the esophageal mucosal layer perfectly and reduce the complications such as infection and other complications associated with the removal of the whole layer of esophagus.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.1

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