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首页> 外文期刊>Surgical Endoscopy >Submucosal tunneling endoscopic resection for submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: A feasibility study (with videos)
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Submucosal tunneling endoscopic resection for submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: A feasibility study (with videos)

机译：黏膜下隧道内窥镜下切除源自固有肌层的食管胃交界处黏膜下肿瘤的可行性研究（附视频）

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Background: The esophagogastric junction (EGJ) is a difficult location for endoscopic resection due to its narrow lumen and sharp angle. Potential increased risks of perforation and mediastinal infection exist, especially for submucosal tumors (SMTs) originating from the muscularis propria (MP) layer. We previously demonstrated the safety and efficacy of submucosal tunneling endoscopic resection (STER) for upper gastrointestinal SMTs, but the feasibility of STER for the removal of SMTs at the EGJ requires systematic investigation. The aim of the investigation was to evaluate the clinical impact of STER on the removal of SMTs at the EGJ. Methods: A prospective study was carried out which included a consecutive cohort of 57 patients who underwent STER for 57 SMTs of the EGJ originating from the MP layer between July 2010 and August 2012 in a single academic medical center. Adverse events, en bloc resection rate, and local recurrence were evaluated. Results: The average maximum diameter of the lesions was 21.5 mm (range 6-35 mm). The en bloc resection rate was 100 % (57/57). No delayed hemorrhage or severe adverse events occurred in any of the 57 patients following STER. No local recurrence and distant metastasis occurred during 24 months' follow-up. Less subcutaneous emphysema and pneumomediastinum absorption time (p = 0.005) occurred with CO2 versus air insufflations. Conclusions: Our study showed that STER was safe and effective, provided accurate histopathologic evaluation, and was curative for SMTs of the deep MP layers at the EGJ. CO2 gas insufflation is recommended.
机译：背景：食管胃交界处（EGJ）由于其狭窄的内腔和尖锐的角度而很难在内窥镜下切除。存在穿孔和纵隔感染的潜在风险增加，尤其是对于源自固有肌层（MP）层的粘膜下肿瘤（SMT）。我们先前证明了黏膜下隧道内镜切除术（STER）对于上消化道SMT的安全性和有效性，但是STER在EGJ上去除SMT的可行性需要系统的研究。研究的目的是评估EGJ对STER去除SMT的临床影响。方法：进行了一项前瞻性研究，该研究包括从2010年7月至2012年8月在一个学术医学中心对来自MP层的EGJ的57个SMT进行了STER手术的57例患者。评估不良事件，整体切除率和局部复发。结果：病变的平均最大直径为21.5毫米（范围6-35毫米）。整体切除率为100％（57/57）。在STER后的57例患者中，没有发生延迟性出血或严重不良事件的发生。在24个月的随访中未发生局部复发和远处转移。与空气吹入相比，CO2引起的皮下气肿和肺炎纵隔吸收时间更少（p = 0.005）。结论：我们的研究表明，STER是安全有效的，可提供准确的组织病理学评估，并且可治疗EGJ深MP层的SMT。建议使用二氧化碳气体吹入。

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