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中华普通外科学文献简介:中华普通外科学文献简介,中华普通外科学文献简介[详细]

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中华人民共和国国家卫生健康委员会
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中华医学会
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中山大学附属第一医院
中山大学附属中山医院
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首页 > 期刊列表 > 预荷包缝合在内镜黏膜下剥离术及全层切除术治疗胃黏膜下肿瘤的价值探讨
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标题: 预荷包缝合在内镜黏膜下剥离术及全层切除术治疗胃黏膜下肿瘤的价值探讨
摘要:

目的:探讨预荷包缝合在内镜黏膜下剥离术(ESD)及全层切除术(EFR)治疗胃黏膜下肿瘤(GSMT)的价值。方法:回顾性分析2014年1月至2018年1月在西电集团医院行手术治疗的72例腔外生长型GSMT患者资料,根据手术方式分为观察组和对照组。观察组39例,于病灶未穿孔前行预荷包缝合,继而行EFR;对照组33例,行ESD常规剥离病灶穿孔后,再行荷包缝合。比较两组患者病变大小、手术时间、术后并发症、住院时间、术后恢复情况。结果:观察组手术时间为(3.7±0.8)h,显著低于对照组的(5.1±0.9)h,差异有统计学意义(t=4.159,P=0.038);两组胃管留置时间、住院时间比较,差异均无统计学意义(t=0.605、0.416,P=0.524、0.702);所有患者均顺利完成R0切除手术,术后观察组出现轻微腹痛3例(7.69%),对照组出现腹痛6例(18.18%),观察组术后并发症发生率显著低于对照组,差异有统计学意义(χ2=6.373,P=0.012)。术后1个月复查,观察组发生创面溃疡1例,对照组发生创面溃疡2例,差异无统计学意义(χ2=0.348,P=0.555);术后2个月所有患者均恢复良好,未出现明显残留、复发症状。结论:对于腔外生长型GSMT,金属夹与尼龙绳联合行内镜下预荷包缝合术是一种可靠的治疗方式,因手术时间短、并发症发生率低、术后恢复快的特点,具有较高的临床应用价值。

英文摘要: Objective:To investigate the value of preloaded sutured endoscopic submucosal dissection (ESD) and endoscopic full-thickness resection (EFR) for gastric submucosal tumors (GSMT). Methods:From January 2014 to January 2018, seventy-two patients with GSMT of extraluminal growth type who underwent surgical treatment in XD Group Hospital were retrospectively analyzed. They were divided into observation group and control group according to the surgical method. Thirty-nine patients in the observation group underwent pre-loading suture before the lesion was perforated, followed by EFR. Thirty-three patients in the control group underwent perforation of the ESD conventional exfoliation lesions. The lesion size, operation time, postoperative complications, hospital stay, and postoperative recovery were compared between the two groups. Results:The operation time of the observation group was (3.7±0.8) h, which was significantly lower than that of the control group (5.1±0.9) h, the difference was statistically significant (t=4.159, P=0.038). There were no differences in comparison of gastric tube indwelling time and hospitalization time between the two groups (t=0.605, 0.416,P=0.524, 0.702). All patients underwent R0 resection successfully, 3 cases (7.69%) of the observation group had mild abdominal pain, and abdominal pain occurred in 6 cases (18.18%) of the control group. The incidence of postoperative complications in the observation group was significantly lower than that of the control group, the difference was statistically significant (χ2=6.373, P=0.012). One month after the operation, one case of wound ulcer occurred in the observation group and two cases in the control group, with no significant difference (χ2=0.348, P=0.555). All patients recovered two months after operation, and no obvious residual or recurrence symptoms appeared. Conclusion:For the treatment of extracavity growing GSMT, endoscopic preloading suture with metal clip and nylon cord is reliable, which has a high clinical value because of shorter operation time, lower complication rate and rapid postoperative recovery.
作者:

董伟;杨小飞

作者单位: 西安,西电集团医院普通外科
期刊: 中华普通外科学文献(电子版)
年.卷(期):页码 2019 .13(5):385-388
中图分类号:
文章编号:
引用格式: [1]董伟;杨小飞.预荷包缝合在内镜黏膜下剥离术及全层切除术治疗胃黏膜下肿瘤的价值探讨[J/CD].中华普通外科学文献(电子版),2019,13(5):385-388 .
关键词: 胃肿瘤;缝合技术;黏膜下肿瘤;预荷包缝合
英文关键词: Stomach neoplasms;Suture technique;Submucosal tumor;Preloaded suture

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