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目的探讨食管平滑肌瘤的诊断、鉴别诊断及手术治疗方法。方法食管平滑肌瘤患者55例均行食管平滑肌瘤切除术,并根据术前X线食管钡剂造影等影像资料进行临床分型。结果本组中食管平滑肌瘤Ⅰ型5例,Ⅱ型39例,Ⅲ型7例,Ⅳ型4例;行传统开胸黏膜外食管平滑肌瘤摘除+肌层修补术38例,电视胸腔镜黏膜外平滑肌瘤摘除术6例,肿瘤及食管部分切除消化道重建术9例,内镜电切术2例;无手术死亡及复发;术后并发瘢痕性食管狭窄2例经扩张后好较,并发食管憩室1例未做处理。结论食管平滑肌瘤手术治疗效果满意,分析其临床分型有助于手术方式选择。
Objective To investigate the diagnosis, differential diagnosis and surgical treatment of esophageal leiomyoma. Methods 55 patients with esophageal leiomyoma were performed resection of esophageal leiomyoma, and according to preoperative X-ray esophageal barium contrast imaging data for clinical classification. Results There were 5 cases of type Ⅰ esophageal leiomyoma in type Ⅰ, 39 cases of type Ⅱ, 7 cases of type Ⅲ and 4 cases of type Ⅳ. Thirty-eight cases of traditional esophageal leiomyoma were resected with myometrial repair, Mucosal leiomyomatactomy in 6 cases, tumor and esophageal resection of digestive tract reconstruction in 9 cases, endoscopic resection in 2 cases; no surgical mortality and recurrence; 2 cases of postoperative cicatricial esophageal stricture after dilation One case of esophageal diverticulum was not treated. Conclusion The surgical treatment of esophageal leiomyoma is satisfactory, and its clinical classification is helpful to choose the surgical method.