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目的探讨内镜圈套器切除治疗食管粘膜肌层平滑肌瘤的临床疗效及复发因素。方法选择2014年12月至2015年6月,在沈阳军区总医院内镜及超声内镜诊断的食管粘膜肌层平滑肌瘤患者41例为研究对象,采用内镜圈套器切除进行治疗,并评价治疗效果。结果本组41例食管平滑肌瘤患者,行内镜下圈套切除治疗,均取得成功。5例患者术中发现创面边缘肿瘤组织残留,近端缘4例,远端缘1例。应用活检钳切除残留组织3例,追加圈套切除2例,残留组织切除成功。所有患者随访至2015年10月,未见复发。结论术中边缘残留是内镜圈套器切除食管粘膜肌层平滑肌瘤复发的主要原因。术中内镜切除边缘审查可有效预防复发。
Objective To investigate the clinical efficacy and recurrence factors of endoscopic transscleral excision for the treatment of esophageal mucosa leiomyomata. Methods From December 2014 to June 2015, 41 patients with esophageal myometrial leiomyoma diagnosed by endoscopic and endoscopic ultrasonography in Shenyang Military Region General Hospital were enrolled in this study. The patients were treated by endoscopic snare excision and evaluated treatment effect. Results In this group of 41 patients with esophageal leiomyoma, endoscopic transthoracic resection were successful. Five patients were found in the edge of the tumor tissue residual tumor, 4 cases of proximal margin, distal margin in 1 case. Surgical removal of residual tissue biopsy forceps in 3 cases, an additional trap in 2 cases, residual tissue resection success. All patients were followed up until October 2015, and no recurrence was found. Conclusions Intraoperative edge remnant is the main reason of resection of esophageal muscular leiomyoma by endoscopic snare. Intraoperative endoscopic excision can effectively prevent recurrence.