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目的探讨内镜黏膜下肿瘤挖除改良术在上消化道间质瘤治疗中的临床效果。方法选取福建医科大学附属三明第一医院2013—2016年收治的行内镜下治疗的上消化道间质瘤患者77例,根据手术类型不同分为传统组22例与改良组55例,传统组患者予以内镜黏膜下挖除术(ESE)治疗,改良组患者予以ESE改良术治疗,术后随访1.0~1.5年。比较两组患者并发症发生率、转外科手术率、术中出血量、手术时间、手术费用及术后病理和随访情况。结果两组患者术后出血率、转外科手术率比较,差异无统计学意义(P>0.05)。改良组穿孔率低于传统组(P<0.05)。改良组手术时间短于传统组,术中出血量、手术费用少于传统组(P<0.05)。所有患者均随访1.2年,术后复查胃镜创面愈合良好,无复发及转移病例。结论改良的ESE技术应用于上消化道间质瘤治疗,不仅可完整切除瘤体,还可降低并发症发生率,缩短手术时间,降低手术费用。
Objective To investigate the clinical effect of endoscopic submucosal tumor excavation in the treatment of upper gastrointestinal stromal tumors. Methods Totally 77 cases of upper gastrointestinal stromal tumors undergoing endoscopic treatment in Sanming First Affiliated Hospital of Fujian Medical University from 2013 to 2016 were divided into two groups according to the type of operation: 22 cases in the traditional group and 55 cases in the modified group, Patients were treated with endoscopic submucosal excavation (ESE), and patients in the modified group were treated with ESE. Postoperative follow-up was 1.0 to 1.5 years. The incidence of complications, surgical rate, intraoperative blood loss, operation time, operation cost and postoperative pathology and follow-up were compared between the two groups. Results There was no significant difference in postoperative bleeding rate and surgical rate between the two groups (P> 0.05). The perforation rate of the modified group was lower than that of the traditional group (P <0.05). The operation time of the modified group was shorter than that of the traditional group, the amount of bleeding during operation and the operation cost less than the traditional group (P <0.05). All patients were followed up for 1.2 years, postoperative gastroscope wound healing, no recurrence and metastasis. Conclusion The modified ESE technique is applied in the treatment of upper gastrointestinal stromal tumors, which not only can completely remove the tumor, but also reduce the incidence of complications, shorten the operation time and reduce the cost of operation.