Abstract:
Gastric duplication cysts (GDCs) are rare structural abnormalities, especially in adults. We first report a rare case of small multiple GDCs in a woman, which presents as a submucosal tumor (SMT) at the gastric antrum. In consideration of the patient\'s request for surgical treatment and minimally invasive resection, endoscopic submucosal dissection (ESD) was performed to remove the cyst. The case provides a reference for ESD surgery to remove small GDCs. So far, there is no consensus or practice guidelines for the diagnosis and management of GDCs. Herein we perform a comprehensive literature review and discussion on GDCs. GDCs are \'repetitive\' cystic or tubular structures of gastric mucosa and muscularis mucosae, and share the muscularis propria and serous layer with the normal gastric wall. GDCs protruding into the stomach cavity can be diagnosed by endoscopic ultrasound (EUS), which has higher specificity and accuracy than CT and MRI. Some GDCs may cause complications, even cancerization. Therefore, we suggest that once found, the GDCs could be completely resected. For GDCs protruding into the stomach cavity, endoscopic surgery such as ESD can be adopted to remove the lesion. Endoscopic full-thickness resection (EFTR) may become an option for larger GDCs in the future. For extraluminal GDC, laparoscopic surgery is currently preferred. In this review, we summarized the structural and histopathological characteristics of GDCs and various treatment therapies, in order to provide experience and reference for the diagnosis and treatment of GDCs in the future.
摘要:
胃重复囊肿(GDC)是罕见的结构异常,尤其是在成年人中。我们首先报道了一个罕见的女性多发性小GDCs病例,表现为胃窦粘膜下肿瘤(SMT)。考虑到患者的手术治疗和微创切除的要求,采用内镜黏膜下剥离术(ESD)切除囊肿.该病例为ESD手术切除小GDC提供了参考。到目前为止,对于GDCs的诊断和管理尚无共识或实践指南.在此,我们对GDC进行了全面的文献回顾和讨论。GDC是胃粘膜和粘膜肌层的“重复”囊性或管状结构,并与正常胃壁共享固有肌层和浆液层。可以通过内窥镜超声(EUS)诊断突出到胃腔的GDC,比CT和MRI具有更高的特异性和准确性。一些GDC可能会引起并发症,甚至癌症。因此,我们建议一旦发现,GDC可以完全切除。对于突入胃腔的GDC,可采用ESD等内镜手术切除病灶。内镜全层切除术(EFTR)可能成为未来更大的GDC的选择。对于管腔外GDC,目前首选腹腔镜手术。在这次审查中,我们总结了GDC的结构和组织病理学特征以及各种治疗方法,以期为今后GDCs的诊断和治疗提供经验和参考。