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[目的]分析内镜黏膜下挖除术(ESE)治疗术前误诊为胃间质瘤(GSTs)病变的过程,探讨ESE治疗类似GSTs肿瘤的有效方法。[方法]回顾性分析2010年1月~2014年6月经普通胃镜和超声胃镜(EUS)拟诊为GSTs,并行ESE治疗,术中和术后证实为异位胰腺和血管瘤的患者临床资料。[结果]23例患者术前拟诊为GSTs。所有患者均行ESE治疗,术中发现异位胰腺21例,血管瘤2例。ESE治疗异位胰腺和血管瘤过程中易出血,大部分患者采用氩离子血浆凝固术(APC)、直接电凝方法止血,少数患者采用热活检钳或金属钛夹止血,无转外科止血病例。23例患者中3例发生穿孔,均采用金属钛夹成功闭合穿孔。术中判断与术后病理结果吻合。[结论]ESE治疗类似GSTs肿瘤时根据肿瘤特点选择不同的处理方式,同样可有效切除肿瘤。
[Objective] To analyze the procedure of endoscopic submucosal excision (ESE) for the misdiagnosis of gastric stromal tumors (GSTs) and to explore the effective methods of ESE in treating GSTs-like tumors. [Methods] The clinical data of patients with GSTs diagnosed as ectopic pancreas and hemangiomas during operation from January 2010 to June 2014 by ESG and endoscopic ESE were retrospectively analyzed. [Results] Twenty-three patients were preoperatively diagnosed as GSTs. All patients underwent ESE treatment. 21 cases of ectopic pancreas and 2 hemangiomas were found during operation. ESE is easy to hemorrhage in the process of ectopic pancreas and hemangioma. Most patients use argon plasma coagulation (APC) and direct coagulation to stop bleeding. In a small number of patients, the use of thermal biopsy forceps or metal titanium clips to stop bleeding, without surgical hemostasis. Perforation occurred in 3 of 23 patients, all of whom were successfully closed and perforated with titanium clips. Intraoperative judgment and postoperative pathological findings. [Conclusion] ESE treatment of similar GSTs tumors according to the characteristics of the tumor to choose a different treatment, the same can effectively remove the tumor.