2022 年第 5 期 第 17 卷

内镜经黏膜下隧道肿瘤切除术与传统内镜下全层切除术治疗胃黏膜下肿瘤的效果和安全性比较

Efficacy and safety of submucosal tunneling endoscopic resection versus traditional endoscopic full-thickness resection on the treatment of gastric submucosal tumors

作者：庄坤原姗姗闫媛左利平唐海灵郭汉青

英文作者：Zhuang Kun Yuan Shanshan Yan Yuan Zuo Liping Tang Hailing Guo Hanqing

单位：陕西省西安市中心医院消化科，西安710003

英文单位：Department of Gastroenterology Xi′an Central Hospital Shaanxi Province Xi′an 710003 China

关键词：胃黏膜下肿瘤；黏膜下隧道技术；内镜下肿瘤切除术

英文关键词：Gastricsubmucosaltumor;Submucosaltunneltechnology;Endoscopictumorresection

• 摘要：

• 目的 比较内镜经黏膜下隧道肿瘤切除术（STER）与传统内镜下全层切除术治疗胃黏膜下肿瘤的效果和安全性。方法 选取2018年1月至2020年1月陕西省西安市中心医院收治的胃黏膜下肿瘤患者90例。应用随机数字表法分为对照组和观察组，各45例。对照组行传统内镜下全层切除术治疗，观察组行STER治疗。比较2组手术时间、手术费用、住院时间、完整切除率和整块切除率，CD117、CD34和S-100蛋白表达情况，手术并发症和术后随访情况。结果 2组手术时间、手术费用、完整切除率和整块切除率比较差异均无统计学意义（均P>0.05）；观察组住院时间短于对照组［(4.2±0.6)d比（10.5±2.5）d］，CD117、CD34、S-100蛋白阳性表达率和术后1个月创面完全愈合率均高于对照组［73.3%(33/45)比33.3%（15/45）、66.7%(30/45)比40.0%（18/45）、64.4%(29/45)比22.2%（10/45）、91.1%(41/45)比33.3%（15/45）］,术后并发症发生率和术后12个月肿瘤残留率、肿瘤复发率均低于对照组［8.9%(4/45)比28.9%（13/45）、0（0/45）比15.6%（7/45）、2.2%(1/45)比22.2%（10/45）］（均P＜0.05）。结论  STER治疗胃黏膜下肿瘤与传统内镜下全层切除术具有相当的肿瘤切除效果，STER在缩短住院时间、降低并发症发生率和改善预后方面更具有优势。

• Objective  To investigate the efficacy and safety of submucosal tunneling endoscopic resection (STER) versus traditional endoscopic full-thickness resection on the treatment of gastric submucosal tumors. Methods Totally 90 patients with gastric submucosal tumors admitted to Xi′an Central Hospital, Shaanxi Province from January 2018 to January 2020 were selected. Patients were randomly divided into control group and observation group. The control group was treated with traditional endoscopic full-thickness resection, and the observation group was treated with STER. The operation time, operation cost, length of stay, complete resection rate, whole block resection rate, the expression of CD117, CD34 and S-100 protein, surgical complications and postoperative follow-up were compared between the two groups. Results  There were no significant differences in operation time, operation cost, complete resection rate and whole block resection rate between the two groups (all P>0.05). The length of stay of the observation group was shorter than that of the control group ［(4.2±0.6)d vs (10.5±2.5)d］, the positive expression rates of CD117, CD34 and S-100 protein and the complete wound healing rate 1 month after operation of the observation group were higher than those of the control group ［73.3%(33/45) vs 33.3%(15/45), 66.7%(30/45) vs 40.0%(18/45), 64.4%(29/45) vs 22.2%(10/45), 91.1% (41/45) vs 33.3% (15/45)］, and the incidence of postoperative complications, tumor residual rate and tumor recurrence rate 12 months after operation of the observation group were lower than those of the control group ［8.9%(4/45) vs 28.9%(13/45), 0（0/45） vs 15.6%(7/45), 2.2%(1/45) vs 22.2%(10/45)］ (all P<0.05). Conclusions The treatment of gastric submucosal tumor with STER has the same effect of tumor resection as traditional endoscopic full-thickness resection. STER has advantages in shortening the length of stay, reducing the incidence of complications and improving the prognosis.