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目的探讨内镜黏膜下剥离术(ESD)治疗胃间质瘤的疗效和安全性。方法对胃间质瘤应用头端弯曲的针形切开刀进行ESD治疗:(1)黏膜下注射生理盐水;(2)预切开病变周围黏膜;(3)剥离黏膜下层组织显露病变,一次性完整切除病变。结果24例胃间质瘤,20例病变一次性完整剥离,4例未能剥离后接受外科手术。ESD手术时间25~140min(平均62.5min)。1例术中出现消化道穿孔,应用金属夹成功闭合。术中平均出血量约50ml,术后均未出现出血,亦未出现其他并发症。结论ESD治疗胃间质瘤安全、有效,大多可以一次性完整切除病变,提供完整的病理学诊断资料,达到外科手术同样的疗效。
Objective To investigate the efficacy and safety of endoscopic submucosal dissection (ESD) in the treatment of gastric stromal tumors. Methods The treatment of gastric stromal tumors with a tip-bent needle-shaped cutting knife for ESD treatment: (1) submucosal injection of saline; (2) pre-cut lesions around the mucosa; (3) peel submucosa lesions revealed once Complete removal of the lesion. Results Twenty-four cases of gastric stromal tumors were completely exfoliated in one time and four cases were not surgically treated. ESD operation time 25 ~ 140min (average 62.5min). One case of gastrointestinal perforation occurred, the application of metal clip closed successfully. The average intraoperative blood loss of about 50ml, no bleeding after surgery, there were no other complications. Conclusion ESD treatment of gastric stromal tumors safe and effective, most of them can be a one-time complete resection of the lesion, provide complete pathological diagnostic data to achieve the same surgical effect.