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内镜下全层切除十二指肠黏膜下肿瘤的临床疗效分析

Clinical analysis of endoscopy full-thickness resection of duodenal submucosal tumors

  • 摘要: 目的:探讨内镜下全层切除(EFR)治疗十二指肠黏膜下肿瘤(SMT)的可行性及安全性。方法:回顾性分析2015年4月至2017年12月我院经内镜下EFR术治疗12例十二指肠SMT患者的临床资料,了解病变特点、手术过程、手术治疗效果及并发症情况。结果:12例十二指肠SMT行内镜下EFR切除术,病变平均最大径(3.375±0.4)cm,其中4例病灶向腔外生长,EFR平均时间40.5 min,术中2例出血量较大;2例术后迟发性出血,1例经保守治疗出血停止、1例经内镜再次止血成功。4例出现中上腹较剧烈持续性疼痛,经对症处理缓解。术后病理间质瘤最多,为6例。结论:十二指肠SMT内镜下EFR切除术安全有效,可作为十二指肠肠黏膜下较大肿瘤,特别是向腔外生长病变内镜微创治疗的选择之一。

     

    Abstract: Objective:To investigate the feasibility and safety of endoscopic full-thickness resection (EFR) for duodenal submucosal tumors (SMTs). Methods:The retrospective study included a total of 12 patients with duodenal SMTs who underwent EFR from April 2015 to December 2017 in our hospital. Characteristics of the tumors, clinical data, treatment outcomes, and complications were analyzed. Results:Twelve patients with duodenal SMTs successfully underwent EFR. The average tumor diameter was (3.375±0.4) cm, all of the tumors were closed to the muscularispropria, and four presented exophytic growth. The average operation time was 40.5 min. Massive bleeding occurred in two cases during the procedure. Two patients experienced postoperative delayed hemorrhage, one was managed conservatively, the other one was also managed successfully by endoscopic methods. Four patients developed severe upper central abdominal pain, all of them were relieved by symptomatic treatment. Pathology reports showed that, six lesions were stromal tumors, which was the main type. Conclusions:EFR of duodenal SMTs is a safe and effective technique, which could be used as one of the options for endoscopic minimally invasive treatment of large SMTs, especially for extraluminal growth lesions.

     

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