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Clinical Value of ESD Guided by Mini-probe Endoscopic Ultrasonography in the Diagnosis and Treatment of Gastric Mucosal Protrusion Lesions |
ZHOU Xiangrong, XU Dahai, PENG Qinghai, et al |
Jianyang People's Hospital, Sichuan Chengdu641400, China |
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Abstract Objective: To investigate the clinical value of endoscopic submucosal dissection (ESD) guided by mini-probe endoscopic ultrasonography in the diagnosis and treatment of gastric mucosal protrusion lesions. Methods: The clinical data of 194 patients with gastric mucosal protrusion confirmed by operation and pathology were analyzed retrospectively. The diagnostic value of micro probe endoscopic ultrasonography and general gastroscopy in gastric mucosal protuberant lesions were analyzed. 194 patients were divided into ESD group (n=102) and EMR group (n=92) according to the operation mode. The operation related indexes (whole resection rate, operation time, intraoperative bleeding volume) and complications were recorded. The difference of stress response (noradrenaline (NE), cortisol (COR)) between the two groups before and 1 day after operation was compared. Results: Of the 194 patients with gastric mucosal protrusion lesions, there were 78 cases of polyps, 51 cases of interstitialoma, 42 cases of liomyoma and 23 cases of lipomyoma. The diagnostic accuracy rate of mini-probe endoscopic ultrasonography was significantly higher than that of common gastroscopy in the diagnosis of gastric mucosal protrusion lesions (P<0.05). The block resection rate in ESD group was significantly higher than that in EMR group (P<0.05), and the surgery time and intraoperative blood loss were lower than those in EMR group (P<0.05). There were no significant differences in the perioperative complications between the two groups (P>0.05). At 1d after surgery, the stress response indexes (serum NE, Cor) were higher than those before surgery (P<0.05), and the indexes in EMR group were higher than those in ESD group (P<0.05). Conclusion: ESD by mini-probe endoscopic ultrasonography has significant effects in the diagnosis and treatment of gastric mucosal protrusion lesions, and can reduce the surgical stress response, and it is of positive significance in promoting postoperative recovery.
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[1] 林昱,陈泽庭.奥曲肽联合凝血酶治疗肝硬化合并上消化道出血的疗效观察[J].河北医学,2017,23(5):809~812. [2] 黄军,郑海伦,王启之,等.微探头超声内镜辅助内镜治疗消化道黏膜下肿物291例临床分析[J].中华全科医学,2017,15(12):2038~2041. [3] Ferlitsch M,Moss A,Hassan C,et al.Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.[J].Endoscopy,2017,49(3):270~297. [4] Ariyoshi R,Toyonaga T,Tanaka S,et al.Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms extending to the cervical esophagus.[J].Endoscopy,2017,50(6):613~617. [5] 李梦颖,喻军,谢扬,等.超声内镜鉴别胃内间质瘤和平滑肌瘤的价值[J].胃肠病学和肝病学杂志,2018,27(3):321~324. [6] 王晓凡,李峥,高山,等.内镜黏膜下剥离术前内镜超声标准超声探头检查避免微探头对食管胃间质瘤大小的误判[J].胃肠病学,2017,22(2):70~74. [7] 徐康,金海林,丁玺,等.内镜黏膜下剥离术治疗早期结直肠癌的应用价值与安全性评估[J].中国内镜杂志,2018,24(5):17~22. [8] Noguchi M,Yano T,Kato T,et al.Risk factors for intraoperative perforation during endoscopic submucosal dissection of superficial esophageal squamous cell carcinoma[J].World Journal of Gastroenterology,2017,23(3):478~485. [9] Mori H,Kobara H,Guan Y,et al.Oval mucosal opening bloc biopsy after incision and widening by ring thread traction for submucosal tumor[J].World Journal of Gastroenterology,2017,23(39):7185~7190. [10] 刘冠伊,戎龙,年卫东,等.早期结直肠癌内镜治疗方式的探讨[J].中华消化内镜杂志,2017,34(10):704~708. [11] Probst A,Pommer B,Golger D,et al.Endoscopic submucosal dissection in gastric neoplasia - experience from a European center[J].Endoscopy,2017,49(3):222~232. [12] 陈保银,马竹芳,刘畅.上消化道黏膜下隆起性病变行微探头超声内镜联合内镜黏膜下剥离术的诊治研究[J].现代消化及介入诊疗,2017,22(5):676~678. |
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