2015 年第 2 期 第 13 卷

食管间质瘤手术方式的选择

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关键词：食管间质瘤内镜粘膜下剥离术肿瘤摘除术食管切除术

• 摘要：
• 【摘要】目的 探讨不同的手术方式对食管间质瘤患者短期及长期效果的影响。方法 回顾性分析我院1999年1月至2013年12月收治的经手术切除的28例食管间质瘤患者的临床资料及治疗方案。结果 所有患者均接受手术切除，内镜粘膜下剥离术4例、肿瘤摘除术13例、食管切除术11例，平均肿瘤直径分别为1.0±0.4cm、2.8±1.8cm、7.8±3.8cm（P＜0.001）；平均手术时间分别为66.3±14.9min、91.9±22.8min、246.4±29.2min（P＜0.001）;术后平均住院时间分别为6.5±0.6d、9.7±0.6d、12.4±0.9d（P=0.001）；围手术期并发症发生率分别为0/4、0/13、3/11（P=0.096）。中位随访48月（3-156月），2例接受食管切除术的患者出现复发和/或转移，1例出现肝脏转移，1例出现局部复发和肝脏转移，并死于食管间质瘤。结论 手术切除为食管间质瘤的主要治疗手段，内镜粘膜下剥离术和肿瘤摘除术对于早期病变可取得良好的治疗效果。
• Objective The aim of this study is to investigate the effect of different surgical options on the short- and long-term outcomes of patients with esophageal gastrointestinal stromal tumors (E-GISTs)．Methods The clinical and treatment characteristics of 28 consecutive E-GISTs patients who underwent curative resection at our insititution between January 1999 and December 2013 were retrospectively reviewed. Results All the patients underwent curative surgery, including endoscopic submucsal dissection(ESD, n=4), enucleation(n=13), esophagectomy(n=11). The mean tumor size was 1.0±0.4cm, 2.8±1.8cm, 7.8±3.8cm（P＜0.001）, respectively. The mean operative time was 66.3±14.9min, 91.9±22.8min, 246.4±29.2min（P＜0.001）, respectively. The mean postoperative hospital stay was 6.5±0.6d, 9.7±0.6d, 12.4±0.9d（P=0.001）, respectively. The perioperative complication rate was 0/4、0/13、3/11（P=0.096）, respectively. After a median follow-up of 48 months (range3-156 months), two patients who underwent esophagectomy experienced recurrence, one patients developed liver metastasis, one patients developed local recurrence and liver metastasis. Conclusions Surgical resection remains mainstay for the treatment of E-GISTs, ESD and enucleation are the preferred surgical option.