中国实用外科杂志

中国实用外科杂志

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腹腔镜在胃间质瘤手术治疗中应用价值研究

李子禹a，邢兆东a，王    警b，吴    齐b，苏向前c，季加孚a   

  1. 恶性肿瘤发病机制及转化研究教育部重点实验室 北京大学肿瘤医院暨北京市肿瘤防治研究所 a.胃肠肿瘤外科 b.内镜中心 c.胃肠肿瘤微创外科，北京100142
  • 出版日期:2015-04-01 发布日期:2015-03-31

  • Online:2015-04-01 Published:2015-03-31

摘要：

目的    探讨腹腔镜手术治疗胃间质瘤的适应证及安全性。方法    回顾性分析北京大学肿瘤医院2007年7月至2014年9月腹腔镜下胃间质瘤切除手术58例（腹腔镜组）和开腹胃间质瘤切除手术99例（开腹组），比较两组间手术相关临床资料。结果    腹腔镜组在手术时间及住院时间等方面与开腹组差异无统计学意义（118 min vs. 110 min，P=0.272；8.5d vs. 8.9 d，P=0.684），但出血量明显减少（37 mL vs. 66 mL，P<0.05），切口长度显著缩小（5.1 cm vs. 15.7 cm，P<0.05）。肿瘤大小方面，腹腔镜组瘤体均值明显小于开腹组（3.9 cm vs. 5.5 cm，P<0.05）。两组术后均未发生出血、瘘等严重并发症。腹腔镜组和开腹组的中位随访时间分别为29个月和36个月，腹腔镜组未出现复发转移，开腹组中有2例高危病人出现复发。结论    对于较小肿瘤，腹腔镜手术治疗胃间质瘤与开腹手术同样安全、可行且微创。

关键词: 胃间质瘤, 腹腔镜, 胃切除术

Abstract:

Laparoscopic resection for gastric stromal tumor        LI Zi-yu*, XING Zhao-dong, WANG Jing, et al.  *Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education of China), Beijing 100142, China
Corresponding author: LI Zi-yu, E-mail: ligregory@outlook.com
Abstract    Objective    To evaluate the indication and safety of laparoscopic resection for gastric stromal tumor.　Methods    The clinical data of 58 cases of GIST performed laparoscopic gastric resection (LR) and 99 cases performed open gastric resection (OR) from July 2007 to September 2014 at Peking University Cancer Hospital and Institute were compared retrospectively. Results    Compared with the OR group, the LR group showed no significant difference in postoperative hospital stay [8.5 d vs. 8.9 d, P=0.684] and operation time [118 min vs. 110 min, P=0.272]. However, the bleeding volume in the LR group was less [37 mL vs. 66 mL, P=0.000], incision length was shorter [5.1 cm vs. 15.7 cm, P=0.000], and tumor size was smaller [3.9 cm vs. 5.5 cm，P=0.000]. No severe complications such as bleeding and leakage were found in both groups. Median follow up time in the LR group and the OR group was 29 months and 36 months respectively. During the period, no recurrence was detected in the LR group, while recurrence was found in two cases of high risk in the OR group. Conclusion    Laparoscopic resection is safe, feasible and minimally invasive for the small gastric stromal tumor and can get the same therapeutic effect as OR.

Key words: gastric tumor, laparoscopy, gastrectomy