应用内镜下圈套器法粘膜切除术治疗上消化道间质瘤李姣陈伟庆.DOC

应用内镜下圈套器法粘膜切除术内镜下圈套器法粘膜切除术内镜下圈套器法R730.56; R735.1; R735.2 Endoscopic mucosal resection with ligator device for Gastrointestinal stromal tumors of upper gastrointestinal tract Li Jiao Chen Weiqing Department of Gastroenterology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China. [Abstract] Objective To evaluate the clinical efficacy, safety, and technical feasibility of Endoscopic mucosal resection with ligator device (EMR-L) for Gastrointestinal (GI) stromal tumors (GISTs) of upper gastrointestinal tract, and to assess its best indications. Methods This is a retrospective medical record review, which includes fifty-three consecutive patients, who underwent EMR-L for GISTs in upper GI tract from May, 2007, to May, 2011. The outcome measures included: clinicopathologic features, results of EUS, EMR-L technique and the complications,  follow-up findings. Results A total of 53 patients were eligible for inclusions in the study, the mean age was 51.7（range, 2276）years, the male/female ratio is 1:2.3（16：37）. EMR-L was easily and successfully performed in 5 patients (success rate, 96.2%), and 2 patients failed and turned to surgery treatment. The mean lesion size under EUS was 0.95(range 0.3～2.5) cm and mean procedure time was 25(range, 14～56) minutes. Complications included gastric perforation 7.5% (4 of 53), retrosternal discomfort 9.4% (5 of 53) and abdominal discomfort 9.4% (5 of 53). The postoperative histological diagnosis was GISTs for all cases, 23 in esophagus and 30 in stomach. During a mean follow-up period of 13.5 months (range, 3～43 months), there was only one recurrence observed 12 months postoperatively with the recurrence rate was 1.9%. Conclusion EMR-L for small (3cm) localized GIST of upper GI tract is an easy, safe, efficacy and less time consuming methods to achieve the satisfying results. [Keywords] Endoscopic treatment; Gastrointestinal stromal tumors; Endoscopic mucosal resection with ligator device Correspo