Endoscopic Submucosal Dissection For Treating Leiomyoma Of Esophagus In 76 Cases

Objective:To investigate the efficacy,safety and clinical analysis of Endoscopic Submucosal Dissection(ESD)in the treatment of esophageal leiomyoma.Methods:Collecting 76 cases of endoscopy and endoscopic diagnosis of esophageal leiomyomas from February 2012 to June 2016 enrolled in our hospital.All patients underwent endoscopy.Endoscopic performance: the esophagus was hemisphere or oval mucosa uplift,to the cavity protrusion,uplift diameter 0.3-3.5cm,base wide,no pedicle,smooth surface.Explain the ESD operation process patient and family members before the operation.Containing the possible results,the existence of the risk and signed informed consent.Routine gastroscopy and improve the time of prothrombin time,blood,electrocardiogram,blood type,blood supply,sedation,anesthesia successfully after the mirror to find the lesion.Peel the mucous membrane and submucosal layer,fully exposed tumor,and then use the knife slowly cut the tumor layer by layer,until the tumor completely resection,surgery closed titanium clip suture wound.Cut the organization under the pathological examination,postoperative anesthesia awakening room observation,fasting after 1 day,semi-liquid diet 3 days,and to acid,bleeding,prevention of infection and other treatment.Followed up endoscopy postoperative 1 and 6 months.Results: Esophageal mucosal muscular layer and intimal muscle mass complete resection rate of 100%,postoperative pathology confirmed to be leiomyoma,no complications,no deaths.The average follow-up period was six months,no recurrence.76 patients with esophageal leiomyoma were successful one-time resection,intraoperative and postoperative observation of all cases of wound healing is well,no bleeding,perforation,esophageal stenosis and other complications.Postoperative pathological examination showed all the samples were leiomyoma.4 cases felt the sternum pain after reating with operation,Using acid treatmentcould release the pain.We found artificial ulcers were formed reexamination by endoscopic.The ulcer has healed into red or white scar followed up from 6 to 12 months.Conclusion: ESD on esophageal leiomyoma can be a one-time large resection,could provide complete pathological diagnosis information,the whole resection of the lesion recurrence rate is low,less complications,is a safe and effective treatment methods.