翻转法内镜全层切除术治疗腔外生长为主胃间质瘤的临床价值（含视频）

Clinical value of reverse endoscopic full‑thickness resection for gastric stromal tumors with a predominant extraluminal growth pattern (with video)

摘要:

目的 评估翻转法内镜全层切除术（reverse endoscopic full‑thickness resection，R‑EFR）治疗腔外生长为主的胃间质瘤的效果和安全性。方法 回顾性收集2019年3月至2024年12月间在台州市立医院或同济大学附属东方医院接受R‑EFR治疗的腔外生长为主的胃间质瘤病例总计50例，依据纳排标准，其中31例纳入数据分析，统计手术完成情况、术后住院时间、并发症发生情况以及随访结果。结果 31例肿瘤均实现整块切除，手术时间15~180 min，中位时间55 min。9例（29.0%）胃壁缺损采用三臂夹闭合，其余22例（71.0%）使用尼龙圈和金属夹缝合。术后住院时间5~7 d，中位时间6 d，仅1例发生并发症（术后感染）。随访时间6~60个月，随访期间未出现复发或转移。结论 研究结果初步显示，腔外生长为主的胃间质瘤行R‑EFR治疗安全、有效。

Abstract:

Objective To evaluate the efficacy and safety of reverse endoscopic full-thickness resection (R-EFR) for treating gastric stromal tumors (GSTs) with predominantly extraluminal growth. Methods Data on 50 cases of GSTs with predominantly extraluminal growth who underwent R-EFR at Taizhou Municipal Hospital or East Hospital Affiliated to Tongji University between March 2019 and December 2024 were retrospectively collected. Based on inclusion and exclusion criteria, 31 cases were included in the data analysis. Surgical completion rate, postoperative hospital stay, incidence of complications, and follow-up outcome were recorded. Results All 31 tumors were completely resected en bloc. Surgical times ranged from 15 to 180 minutes, with a median of 55 minutes. Through-the-scope twin clips were used to close gastric wall defects in 9 cases (29.0%), while nylon ligatures and metal clips were employed in the remaining 22 cases (71.0%). Postoperative hospital stays ranged from 5 to 7 days, with a median of 6 days. Only one case (2.9%) experienced a complication (postoperative infection). The follow-up period ranged from 6 to 60 months, no recurrence or metastasis was observed during the follow-up. Conclusion These preliminary results indicate that R-EFR is a safe and effective treatment for GSTs with predominantly extraluminal growth.