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首页> 外文期刊>Surgical Endoscopy >Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria.
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Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria.

机译：无腹腔镜辅助的内镜全层切除术治疗源自固有肌层的胃黏膜下肿瘤。

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BACKGROUND: This study was designed to evaluate the clinical efficacy, safety, and feasibility of endoscopic full-thickness resection (EFR) for gastric submucosal tumors (SMTs) originated from the muscularis propria. METHODS: Twenty-six patients with gastric SMTs originated from the muscularis propria were treated by EFR between July 2007 and January 2009. EFR technique consists of five major procedures: (1) injecting normal saline into the submucosa and precutting the mucosal and submucosal layer around the lesion; (2) a circumferential incision as deep as muscularis propria around the lesion by the endoscopic submucosal dissection (ESD) technique; (3) incision into serosal layer around the lesion with Hook knife; (4) completion of full-thickness incision to the tumor including the serosal layer with Hook, IT, or snare by gastroscopy without laparoscopic assistance; (5) closure of the gastric-wall defect with metallic clips. RESULTS: EFR was successfully performed in all 26 patients without laparoscopic assistance. The complete resection rate was 100%, and the mean operation time was 105 (range, 60-145) min. The mean resected lesion size was 2.8 (range, 1.2-4.5) cm. Pathological diagnosis of these lesions included gastrointestinal stromal tumors (GISTs) (16/26), leiomyomas (6/26), glomus tumors (3/26), and Schwannoma (1/26). No gastric bleeding, peritonitis sign, or abdominal abscess occurred after EFR. No lesion residual or recurrence was found during the follow-up period (mean, 8 months; range, 6-24 months). CONCLUSIONS: EFR seems to be an efficacious, safe, and minimally invasive treatment for patients with gastric SMT, which makes it possible to resect deep gastric lesion and provide precise pathological diagnosis of it. With the development of EFR, the indication of endoscopic resection may be expanded.
机译：背景：本研究旨在评估内镜全层切除术（EFR）治疗源自固有肌层的胃黏膜下肿瘤（SMT）的临床疗效，安全性和可行性。方法：2007年7月至2009年1月，对26例源自固有肌层的胃SMT患者进行了EFR治疗。EFR技术包括五个主要步骤：（1）将生理盐水注入粘膜下层并在其周围预先切开粘膜和粘膜下层病变（2）通过内镜下粘膜下剥离术（ESD）技术在病变周围深至固有肌层的圆周切口; （3）用钩刀切开病灶周围的浆膜层; （4）在没有腹腔镜辅助的情况下，通过胃镜完成对包括厚膜层，Hook，IT或圈套物在内的肿瘤的全层切口; （5）用金属夹闭合胃壁缺损。结果：在没有腹腔镜辅助的所有26例患者中，均成功进行了EFR。完全切除率为100％，平均手术时间为105分钟（范围60-145）。平均切除病灶尺寸为2.8（范围1.2-4.5）厘米。这些病变的病理诊断包括胃肠道间质瘤（GIST）（16/26），平滑肌瘤（6/26），肾小球肿瘤（3/26）和神经鞘瘤（1/26）。 EFR后未发生胃出血，腹膜炎体征或腹部脓肿。在随访期间（平均8个月;范围6-24个月）未发现病变残留或复发。结论：EFR对于胃SMT患者似乎是一种有效，安全且微创的治疗方法，这使得切除深部胃部病变并提供精确的病理诊断成为可能。随着EFR的发展，内镜切除的适应症可能会扩大。

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