Ann Thorac Surg:胸腔镜食管粘膜下肿瘤剜除术安全可行

2014-01-09 佚名 dxy

食管黏膜下肿瘤(SMTs)通常是良性的,外科剜除术是广泛接受的首选的治疗方法。然而,胃肠道间质瘤(GISTs)有恶变的可能,可能需要接受食管切除,具有较高的并发症发生率和死亡率。通常通过开胸或开腹手术方法治疗。最近有报道采用微创剜除术上治疗食管粘膜下肿瘤,认为这种技术可能难以用于大病灶患者,并且可能增加手术的并发症。 针对这种情况,来自韩国成均馆大学医学院胸心外科的Yong Soo Choi教授

食管黏膜下肿瘤(SMTs)通常是良性的,外科剜除术是广泛接受的首选的治疗方法。然而,胃肠道间质瘤(GISTs)有恶变的可能,可能需要接受食管切除,具有较高的并发症发生率和死亡率。通常通过开胸或开腹手术方法治疗。最近有报道采用微创剜除术上治疗食管粘膜下肿瘤,认为这种技术可能难以用于大病灶患者,并且可能增加手术的并发症。【原文下载

针对这种情况,来自韩国成均馆大学医学院胸心外科的Yong Soo Choi教授等人进行了一项研究,研究结果在线发表于2013年12月17日的《胸外科年鉴》(Ann Thorac Surg)杂志上。作者发现胸腔镜食管粘膜下肿瘤剜除术对大多数患者是可行的,并与住院时间短呈正相关。

该研究回顾性分析1995年至2011年间Samsung医学中心接受剜除术的87例食管(SMTs)进行了回顾性分析。其中男性59人和女性28人,平均年龄43.3岁(范围20-73岁)。作者对这部分患者的一般临床资料,病灶的大小、位置,手术方式和术后并发症等进行了统计分析。

研究结果表明,58例患者无症状。剩余患者中,最常见的症状是吞咽困难(12例)。79例患者进行了经胸超声检查,其中63例接受电视胸腔镜剜除术。8例患者经腹手术切除。

病理诊断:子宫肌瘤(N=78例),胃肠道间质瘤(GISTs)(N=5例),神经鞘瘤(N=3例),以及血管瘤(1例)。胸腔镜剜除术组与开胸组相比显著缩短平均住院时间。

总体而言,2例患者剜除术后出现漏,其中1例接受再次手术。除了这2例患者,无其他严重并发症。1例GISTs患者接受剜除术后复发,行食管切除术。

该研究发现,剜除术后的外科结果都非常好。胸腔镜方法对大多数患者是可行的,并与住院时间短呈正相关。然而,考虑到GISTs的复发风险,剜除术后需要精心管理。

原文出处

Shin S, Choi YS, Shim YM, Kim HK, Kim K3, Kim J.Enucleation of Esophageal Submucosal Tumors: A Single Institution's Experience.Ann Thorac Surg. 2013 Dec 17【原文下载

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    2014-12-14 guoyibin
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    2014-10-04 yyj062
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    2014-01-11 alimjanwushur

    good paper.

    0

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