Endoscopic Band Ligation Combined With Endoscopic Submucosal Dissection In Treatment Of Gastrointestinal Stromal Tumors Clinical Study Of Efficacy And Safety

Gastrointestinal stromal tumors are the most common gastrointestinal mesenchymalodontogenic tumor, originating from the gastrointestinal tract of interstitial cells of Cajal,accounting for about2%of gastrointestinal malignancies, including gastric stromal tumorsaccount for60%-70%, its morbidity has a trend of increase year by year, the late malignanttumor of digestive tract hemorrhage caused by adverse clinical, tumor metastasis the eventhas increased year by year, serious harm to the health of the masses.At present,gastrointestinal stromal tumor of the conventional treatment is a surgical operation excision.Inrecent years, along with the clinical minimally invasive technology development, in view ofearly gastrointestinal stromal tumour of the search for a safe and effective method in clinicaltreatment of endoscopic therapy is the focus of the research on.At present, gastrointestinalstromal tumor minimally invasive operation has two kinds, namely endoscopic ligationtreatment and endoscopic submucosal dissection.Endoscopic variceal ligation treatmentapplied to less than1.2cm in diameter of the tumor.The small trauma, rapid recovery, lowcost.But the method of ligation tumor fall off naturally, unable to obtain complete tumor sentfor histopathological examination; and endoscopic submucosal dissection is extremely easy tolead to perforation, hemorrhage.This study will endoscopic ligation combined with endoscopic submucosal dissection,proposed by ligation to reduce and prevent perforation, hemorrhage, at the same time, byendoscopic submucosal dissection to remove tumor non natural shedding.In order to improvethe minimally invasive treatment of gastrointestinal stromal tumor of the efficacy and safetyof.Research to improve and standardize the combined minimally invasive operationtechnological process and steps.By setting the criteria for inclusion and exclusion criteria, acollection of clinical cases in213cases, including minimally invasive surgery group in132cases, simple endoscopic submucosal dissection81cases.Outcome measures involving general characteristics (age, gender, tumor size, tissue classification) and effectiveness(operation resection, complications, such as medical expenses).The results showed:1．A group of age of16-67years old (mean48+/-10), the male55%, female45%;tumor diameter is0.5-1.2cm; pathological diagnosis of98cases of gastric stromal tumor,extremely low malignant gastric stromal tumor in73cases, accounting for74%(73/98); lowmalignant gastric stromal tumors in25an example, accounted for26%(25/98).2．The case group and the control group cases in age, sex, duration and othercharacteristics were comparable; cases resection rate was100%, compared to the controlgroup (90%) high removal rate (P ABCD=0.01); bleeding rate of1.5%, lower than that ofcontrol group (100%), P ABCD=0.01; two groups intraoperative perforation rate (0.76%)and control group (17.28%), was significantly reduced (P ABCD=0.01); in the treatmentwith titanium clip less number than in the control group (P ABCD=0.01); the cost oftreatment for an average of3333.4per person, than in the control group (3972/person) wassignificantly lower (P=ABCD0.05).3．Relevant data shows, early gastrointestinal stromal tumors using endoscopic ligationcombined with endoscopic submucosal dissection treatment can reduce bleeding, perforationand other complications, improve the safety of endoscopic treatment, and complete resectionof the tumor was sent for histopathological examination, with complete pathologic diagnosis,improve the treatment under endoscope the resection rate, reducing the rate of residual lesions,ensures the curative effect.Not only shorten the hospitalization time, saving the medicalsupplies, reduce the medical costs, and minor trauma, fully embodies the advantages ofminimally invasive endoscopic treatment.