摘要
Abstract
[ Objective ] To evaluate the diagnostic value of endoscopic ultrasonography (EUS) and endoscopic therapies in esophageal submucosal tumors under the guidance of EUS. To assess the clinical efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic piecemeal mucosal resection (EPMR) and endoscopic variceal ligation (EVL) for submucosal tumor (SMT) of theesophagus. [ Methods ] A total of 57 patients with SMT of the esophageal diagnosed by endoscopy were examined using EUS.5 esophageal polypus derived from mucosa. 38 esophageal leiomyoma from muscularis mucosa, 4 lipomas,3 oesophagus cyst, 3 vein tumor, 2 laterally spreading tumor (1ST). EMR or EPMR had been taken according to the different deriving layers, histology and size. Then, the SMT was resected completely. [Results] The resected lesions sized 0.4-3.0 cm in diameter {mean, 1.25 cm). Among the 57 lesions, were successfully resected with EMR. The resected lesions sized over 1.5 cm in diameter, 6 cases
were successfully resected with EPMR, 6 cases oesophagus cyst and vein tumor were successfully endoscopic variceal ligation (EVL). The mean EMR procedure time was 18 min (ranged from 15 to 25 min). Five patients had massive hemorrhage during EMR, which could be controlled under a gastroscope. None of the patients had delayed bleeding. Perforation had not occurred in EMR. Histological evaluation showed that the tunica of the tumors was intact, and both the lateral and basal margins of the specimens were free of tumor cells. Followed up in 1.5 and 3 months after EMR.with confirmed healing of the artificial ulcer with no residue or recurrence. [Conclusions] Different layers of esophageal submucosal tumors can be distinguished clearly by EUS, leading to definite diagnosis of submucosal tumors. EUS is important in selecting treatment procedures of SMT and should routinely be performed on all presumptive submucosal tumors prior to attempt at removal. Most of SMTs are resected simply and safety by EMR.lf the lesions was not resected completely because it is bigger, EPMR is an efficacious and safe procedure for the treatment of SMT of the esophagus. It is possible to completely resect submucosal lesions and provide sufficient pathological information.关键词
超声内镜/内镜下黏膜切除术/内镜下黏膜分片切除术/内镜下套扎术/食管黏膜下肿瘤Key words
endoscopic ultrasonography(EUS)/ endoscopic mucosal resection(EMR)/ endoscopic piecemeal mucosal resection (EPMR)/ endoscopic variceal ligation(EVL)/ esophageal submucosal tumors(SMT)分类
医药卫生
