目的:探讨圈套器辅助牵引内镜下全层切除术(EFTR)治疗胃底黏膜下肿瘤(SMTs)的可行性和有效性。方法:收集2018年1月至2023年6月开封市中心医院内镜中心行EFTR治疗的胃部SMTs患者的临床病理资料。其中,36例患者接受了圈套器辅助牵引EFTR(SAT-EFTR),46例患者接受了标准EFTR(S-EFTR)。临床基线数据,手术数据,不良事件,收集并比较两组的随访结果。结果:所有患者均顺利完成EFTR技术。有34名男性和48名女性患者,平均年龄(56.62±11.31)岁。圈套器辅助EFTR组的平均手术时间短于S-EFTR组(73.39±31.33分钟比92.89±37.57分钟,P=.014)。此外,圈套器辅助EFTR组的切除速度也明显快于S-EFTR组(4.04±2.23比2.48±0.93mm2/min,P<.001)。年龄差异无统计学意义,性别,病变大小,术后禁食时间,两组患者术后住院时间及差异无统计学意义(P>.05)。SAT-EFTR组中的一名患者发生了延迟的术后穿孔,该穿孔与荷包缝合技术接近。所有患者均顺利出院,随访期间无复发或转移。结论:Snare辅助EFTR牵引可缩短手术时间,降低操作难度,提高运营效率。同时,此方法简单易学,更适合初学者,值得临床推广应用。
Aim: To explore the feasibility and effectiveness of
snare-assisted traction endoscopic full thickness resection (EFTR) on gastric fundus submucosal tumors (SMTs). Methods: The clinical and pathological data of patients with gastric SMTs who underwent EFTR treatment at the Endoscopy Center of Kaifeng Central Hospital from January 2018 to June 2023 were collected. Among them, 36 patients underwent
snare-assisted traction EFTR (SAT-EFTR) and 46 patients underwent standard EFTR (S-EFTR). The clinical baseline data, operative data, adverse events, and follow-up results of the two groups were collected and compared. Results: All patients successfully completed EFTR technique. There were 34 male and 48 female patients, with an average age of (56.62 ± 11.31) years. The average operation time was shorter in the
snare-assisted EFTR group than the S-EFTR group (73.39 ± 31.33 minutes versus 92.89 ± 37.57 minutes, P = .014). In addition, the resection speed of the
snare-assisted EFTR group was also significantly faster than that of the S-EFTR group (4.04 ± 2.23 versus 2.48 ± 0.93 mm2/min, P < .001). There was no statistically significant difference in the age, gender, lesion size, postoperative fasting duration, and postoperative hospitalization stay between the two groups (P > .05). One patient in the SAT-EFTR group developed delayed postoperative perforation which was close with purse‑string suture technique. All patients were discharged successfully, and there was no recurrence or metastasis during the follow-up period. Conclusion:
Snare-assisted traction of EFTR could shorten the operation time, reduce the difficulty of the operation, and improve the efficiency of the operation. At the same time, this method is simple and easy to learn, more suitable for beginners, and worthy of clinical promotion and application.