| BackgroundGastrointestinal stromal tumors are the most common mesenchymal tumors of the digestive tract,accounting for about 1%to 2%of gastrointestinal tumors.Among them,gastric stromal tumors are the most common,accounting for about 50-60%.Endoscopic ultrasound has been used in clinical practice since the 1980s and has continued to spread in China,which has greatly improved the detection level of gastric stromal tumors and has an irreplaceable role in the diagnosis of gastric stromal tumors.At present,gastrointestinal stromal tumors are considered to have certain malignant potential,and the key lies in early and complete resection of lesions.Traditional surgical procedures have disadvantages such as large trauma,slow postoperative recovery,and many complications.With the continuous development of endoscopic technology,especially the further maturation of endoscopic mucosal dissection(ESD)and its derivative technologies(EFTR,ESE,STER,etc.),the endoscopic treatment of gastric stromal tumors has gradually become a lot in China.The endoscopic center was developed,but the safety and effectiveness of endoscopic treatment of gastric stromal tumors are still controversial.ObjectiveTo retrospectively analyze the pathological compliance of patients diagnosed with gastric stromal tumor under ultrasound endoscopy to evaluate the diagnostic value of ultrasonic endoscopy for gastric stromal tumors,and further analyze the endoscopic treatment of patients with pathologically confirmed gastric stromal tumors.To evaluate the safety and effectiveness of endoscopic treatment of gastric stromal tumorsMethodsThe retrospective research method was used.The first part collected and analyzed 52 patients who were diagnosed with gastric stromal tumor under ultrasound endoscope from June 2013 to June 2019 and underwent endoscopic treatment at Zhuhai Integrated Chinese and Western Medicine Hospital The clinical data of 36 patients with pathologically confirmed gastric stromal tumors were analyzed in the second part.ResultsAmong all 52 patients,there were 25 males and 27 females,with an average age of 52.72 ± 11.94 years.Postoperative pathological diagnosis:36 cases of gastric stromal tumors,9 cases of leiomyomas,6 cases of ectopic pancreas,and 1 case of schwannomas.There were 26 cases located on the gastric fundus,20 cases were gastric body,5 cases were gastric antrum,and 1 case was cardia.The origin of endoscopic ultrasound:45 cases of lamina propria,6 cases of mucosal muscle layer,and 1 case of submucosal layer.Lesion diameter:23 cases of 1-2 cm,22 cases of ?1 cm,and 7 cases of>2 cm.Echo situation:25 cases was uniform low echo,27 cases was uneven low echo.Compared with other diagnosed cases,the patients with pathologically diagnosed stromal tumors showed significant differences in age,lesion diameter,and endoscopic ultrasound origin between the two groups(P=0.027,0.002,0.007).Multivariate analysis showed that the lesions diameters>1 cm(P<0.003)and endometrial lamina propria(P<0.021)are associated with diagnostic accuracyAll 36 patients had successful endoscopic resection(100%),of which 17 were treated with ESD,13 were treated with EFTR,and 6 were treated with STER.There were 21 cases of gastric fundus,12 cases of gastric body,2 cases of gastric antrum,and 1 case of cardia.The tumor size was 7-35mm,with an average of 15±5.7mm,and the operation time was 32-167 minutes,with an average of 69± 25 minutes.There were 20 cases of surgical complications,including 17 cases of intraoperative perforation,2 cases of 200-250ml of intraoperative bleeding,and 1 case of postoperative infection.The complications were successfully treated conservatively.The postoperative feeding time was 2-8 days,with an average of 3.8 days after surgery,and the postoperative hospitalization time was 3-10 days,with an average of 5.4 days.The postoperative pathological risk classification showed extremely low risk in 29 cases,low risk in 5 cases,intermediate risk in 2 cases,and high risk in 0 cases.Thirty-six patients participated in the follow-up,with a follow-up period of 6 to 56 months,with an average of 18 months.All patients did not relapse.Conclusion1.The results of this study showed that with pathological diagnosis as the gold standard,the diagnostic accuracy rate of gastric stromal endoscopy was about 69.2%The diameter of gastric stromal tumors(>1cm)and the origin of ultrasound endoscopy in the muscularis propria were related to the accuracy of endoscopic diagnosis.2.This study shows that the short-term effect of endoscopic treatment of gastric stromal tumors is positive.Complications such as perforation and hemorrhage are common,but they can be treated conservatively and are safe in general. |
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