内镜用套扎器与经内镜黏膜下隧道法切除食管黏膜下肿瘤的对比研究

Comparison of endoscopic ligation and endoscopic submucosal tunnelling in the treatment of esophageal submucosal tumors

摘要:

目的 对比分析内镜用套扎器与经内镜黏膜下隧道肿瘤切除术（STER）切除食管黏膜下肿瘤（SMTs）的临床效果。方法 回顾性分析66例采用经内镜法切除的食管SMTs患者的临床资料，其中套扎组35例[经内镜套扎器套扎法（直径 < 10 mm）]，STER组31例，对比分析两组手术时间、术中出血量、术后并发症（术后穿孔、出血、气胸和进食障碍）、术后住院时间和手术费用等指标。结果 套扎组手术时间较STER组短[（8.9±1.1）和（62.3±2.8）min]，手术费用较STER组少[（5 126.8±26.5）和（15 721.3±39.6）元]，术中出血量较STER组少[（5.6±1.7）和（42.3±3.5）mL]，两组比较，差异均有统计学意义（P < 0.05）；两组患者术后住院时间和术后并发症发生率比较，差异均无统计学意义（P > 0.05）。结论 治疗直径 < 10 mm的食管黏膜肌层或黏膜下层肿瘤，经内镜套扎法在手术时间、术中出血量和手术费用方面均优于STER组，两种手术方法的住院时间和术后并发症发生率无差异，值得临床推广应用。

Abstract:

Objective To compare the clinical effect of endoscopic ligation and endoscopic submucosal tunnelling in the treatment of esophageal submucosal tumors.Methods Clinical data of 46 patients with submucosal tumors in esophagus underwent endoscopic resection were analyzed retrospectively, including 35 patients who underwent endoscopic ligation (diameter < 10 mm) and 31 patients who underwent endoscopic submucosal tunnelling. The operative time, intraoperative bleeding volume, postoperative complications (perforation, bleeding, pneumothorax, eating disorders), postoperative hospital stay and operation cost were compared and analyzed.Results The operation time was shorter than STER group [(8.9 ± 1.1) min vs (62.3 ± 2.8) min], the operation cost of the endoscopic ligation group was lower than STER group [(5 126.8 ± 26.5) yuan vs (15 721.3 ± 39.6) yuan] and the intraoperative bleeding volume was less than STER group [(5.6 ± 1.7) mL vs (42.3 ± 3.5) mL], The difference were statistically significant (P < 0.05). There was no significant difference in postoperative hospital stay and postoperative complications between the two groups.Conclusion In the treatment of esophageal myometrial or submucosal tumors with a diameter of less than 10 mm, endoscopic ligation is superior to the ster group in terms of operation time, intraoperative bleeding volume and operation cost. There is no significant difference in the length of stay and postoperative complications between the two methods, which is worthy of clinical application.