较大胃间质瘤内镜手术治疗方法的选择及疗效分析

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Abstract Objective To discuss the selection of endoscopic surgery for large gastric stromal tumors and evaluate the clinical efficacy of endoscopic surgery in the treatment of large gastric stromal tumors.Methods The clinical data of 51 patients with gastric stromal tumors who underwent endoscopy in the First Affiliated Hospital of Soochow University and Zhangjiagang First People's Hospital from January 2014 to December 2019 were retrospectively analyzed.According to different surgical methods,they were divided into endoscopic submucosal dissection (ESD) group,endoscopic full-thickness resection (EFR) group and submucosal tunneling endoscopic resection (STER) group.Tumor characteristics,surgical data and follow-up data of the three groups were analyzed and statistically analyzed.Results The tumors in ESD group were distributed in cardia,fundus,body and antrum.In the EFR group,the tumors were mainly located in the fundus of the stomach,rarely in the body and antrum of the stomach.In the STER group,tumors were found in the greater curvature of the gastric body and the cardia.The distribution of tumor sites in the three groups was significantly different (P＜0.05).The maximum diameter of tumors in the STER group was smaller than those in the EFR and ESD group,the difference was statistically significant (P＜0.05).The tumors in ESD group originated from muscularis and submucosa,the tumors in EFR group and STER group originated from muscularis propria,and there were significant differences in the origin of tumors among the three groups (P＜0.05).The tumors in ESD group and STER group were all intraluminal growth,and the tumors in EFR group were mainly extraluminal growth,there were significant differences in tumor growth patterns among the three groups (P＜0.05).There was no significant difference in the complete tumor resection rate among the three groups (P＞0.05).The complication rate of EFR group was higher than that of ESD and STER group,the difference was statistically significant (P＜0.017).All patients were followed up for one year after operation.The wound healing rate of the three groups was 100%,and there was no recurrence or metastasis.Conclusion ESD,EFR and STER have good clinical effects in the treatment of large gastric stromal tumors.Different endoscopic treatments can be selected according to tumor location,size,tumor origin and growth pattern

Key words： Gastric stromal tumor Endoscopic submucosal dissection Endoscopic full-thickness resection Submucosal tunneling endoscopic resection

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I28/73

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