腹腔镜与开腹胃间质瘤楔形切除的临床对比研究

Comparison of Laparoscopic and Open Wedge Resection for Gastric Gastrointestinal Stromal Tumors

目的探讨腹腔镜胃楔形切除治疗胃间质瘤的可行性。方法回顾性分析我院2002年9月~2009年4月腹腔镜胃间质瘤楔形切除术32例（腹腔镜组）和1999年10月~2009年1月开腹胃间质瘤楔形切除术20例（开腹组）的临床资料,比较2组围手术期的情况和预后。结果与开腹组相比,腹腔镜组手术时间短[120 min（23~210 min）vs 145 min（75~400 min）,Z=-2.960,P=0.003],术中出血量少[20 ml（5~100 ml）vs 50 ml（10~200 ml）,Z=-3.580,P=0.000],术后进食时间早[3 d（1~4 d）vs 3 d（3~21 d）,Z=-3.032,P=0.002],术后住院时间短[6 d（4~15 d）vs 8.5 d（6~26 d）,Z=-4.202,P=0.000]。腹腔镜组29例随访6~79个月（中位随访时间25个月）,开腹组16例随访9~120个月（中位随访时间58个月）,均无复发或转移。结论腹腔镜胃间质瘤楔形切除术安全、有效,具有可行性。

Objective To evaluate the feasibility of laparoscopic wedge resection for gastric gastrointestinal stromal tumors.Methods A retrospective comparison was made between laparoscopic（32 cases,performed from September 2002 to April 2009） and open（20 cases,performed from October 1999 to January 2009） wedge resection for gastric gastrointestinal stromal tumors.The pre-intra-and post-operative data of the two groups were compared.Results Compared with the open group,the laparoscopic group presented significantly shorter operation time [120 min（23-210 min） vs 145 min（75-400 min）,Z=-2.960,P=0.003],less blood loss [20 ml（5-100 ml） vs 50 ml（10-200 ml）,Z=-3.580,P=0.000],earlier recovery of bowel functions [3 d（1-4 d） vs 3 d（3-21 d）,Z=-3.032,P=0.002],and shorter postoperative hospital stay[6 d（4-15 d） vs 8.5 d（6-26 d）,Z=-4.202,P=0.000].Follow-up observation was carried out in 29 cases in the laparoscopic group for 6-79 months（median,25 months）,and in 16 cases in the open group for 9-120 months（median,58 months）,respectively.During the periods,no recurrence or metastasis was detected.Conclusion Laparoscopic wedge resection is safe and effective for gastric gastrointestinal stromal tumors.