Objective: To observe the curative effect and safety of endoscopic resection of gastric carcinoma in the treatment of gastric fundus intrinsic muscle tumors. Method: A retrospective analysis of clinical data of 57 patients with gastric fundus inherent muscular layer submucosal tumors in our hospital from January 2012 to January 2015 was performed. The patients were diagnosed and treated by endoscopic ultrasonography and received EFR, and the surgical procedure and postoperative risk of EFR was evaluated. Result: In this group, 57 patients were successfully performed EFR, and the diameter of the lesions was 0.4-4.6cm, and all the lesions were completely resected. Operation time was 27-148min, the average operation time was (45.0±17.4) min. All patients had different degrees of bleeding, the bleeding amount was 10-145mL, the APC or metal clip after successful hemostasis. 2 cases with large perforation were carried out with the method of laparoscopic surgery. After surgery, the patient was hospitalized with 4~15d, and the average length of hospital stay was (5.5±1.7) d. Conclusion: The clinical efficacy of EFR in the treatment of gastric cancer with intrinsic muscle layer can remove the tumor, recurrence rate is low, it is worth promoting.%目的:观察内镜下胃全层切除术(Endoscopic full-thickness resection,EFR)在胃底固有肌层肿瘤治疗中的疗效及安全性.方法:对医院2012年1月-2015年1月收治的胃底固有肌层黏膜下肿瘤患者57例进行临床资料的回顾性分析,患者均经内镜超声确诊并接受EFR,评价EFR治疗的手术过程及术后风险.结果:本组57例患者均顺利完成EFR,术中发现病变直径为0.4-4.6 cm,均一次性完全切除病灶;手术时间27-148 min,平均手术时间为(45.0±17.4)min;术中,所有患者均有不同程度的出血,出血量为10-145 mL,经氩离子凝固术或金属夹闭后均成功止血.术中,有9例患者发生胃穿孔,其中7例采用钛夹夹闭或尼龙圈联合钛夹缝合穿孔成功;另2例患者由于穿孔的直径较大,转腹腔镜进行腔外缝合.术后,患者住院4-15 d,术后平均住院时间为(5.5±1.7)d.结论:EFR治疗胃底固有肌层肿瘤的临床疗效较好,能够完全切除固有肌层肿瘤,复发率低,值得推广.
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