摘要目的 评价贲门及胃底部黏膜下肿瘤(SMT)内镜下全层切除术(EFTR)术后胃壁缺损行单钳道内镜下荷包缝合法封闭的疗效和安全性.方法 32例贲门及胃底部SMT EFTR术后胃壁缺损行单钳道内镜下荷包缝合法封闭的病例资料纳入回顾性分析,总结治疗完成情况、并发症发生情况及随访结果.结果 32例均顺利完成EFTR治疗,病变最大径在1~4 cm,术后胃壁缺损行单钳道内镜下荷包缝合均成功封闭,缝合耗时10~15 min,术后住院时间5~10 d,出现低热13例、上腹部隐痛20例,经保守治疗后均可恢复或缓解.术后1个月32例完成胃镜复查,可见穿孔闭合,其中29例(90.6%)创面仍有钛夹及尼龙绳残留;术后3个月28例完成胃镜复查,可见创面基本愈合,其中15例(46.9%)仍有钛夹残留但无尼龙绳残留.结论 单钳道内镜下荷包缝合法能够有效封闭贲门及胃底部SMT行EFTR治疗形成的胃壁缺损,安全性较高.

abstractsObjective To evaluate the efficacy and safety of single forcep endoscopic purse-string suture closing the wound of cardia and gastric fundus after endoscopic full-thickness resection (EFTR) for patients with submucosal tumor (SMT).Methods The clinical data of 32 patients with wound in the cardia and gastric fundus after EFTR for SMT undergoing single forcep endoscopic purse-string suture in Endoscopy Center of Renmin Hospital of Wuhan University from January 2015 to January 2016 were collected.Completion of operation, postoperative complication and follow-up results of these patients were retrospectively analyzed.Results All of the patients successfully received EFTR and purse-string suture.The maximal diameter of tumors was 1-4 cm.The suture time was 10-15 min, and postoperative hospital stay was 5-10 d.Low fever and upper abdominal pain were found in 13 and 20 cases respectively, and all cases were alleviated or restored after conservative treatment.All patients underwent gastroscopy during follow-up of 1 month, and titanium clip and nylon rope were found on the wound surface in 29 cases (90.6%).Three months after operation, 28 patients underwent gastroscopy, and titanium clip but no nylon rope was detected in 15 cases (46.9%).Conclusion Single forcep endoscopic purse-string suture can effectively treat the postoperative wound in the cardia and gastric fundus of patients with submucosal tumors after EFTR.