三种腹腔镜术式在48例胃间质瘤手术治疗中的临床应用

Clinical application of three kinds of laparoscopic resection of stomach stromal tumor:report of 48 cases

目的总结分析腹腔镜技术在胃间质瘤手术治疗中的应用经验。方法回顾性分析2006年1月至2010年12月期间收治的48例胃间质瘤患者的临床资料。结果 48例患者均完整切除肿瘤,其中全腹腔镜胃部分切除术8例,腹腔镜辅助下行胃间质瘤切除术35例,手辅助腹腔镜胃间质瘤切除术5例。手术时间35-96min。切除标本切缘未发现肿瘤残留;CD117阳性48例（100%）。患者术后恢复顺利,未发生胃切口出血和漏。术后住院时间（6±1.3）d,随诊3-45个月,平均23个月,失访9例,其余病例生存良好。结论按照胃间质瘤的大小与位置选择个体化的手术方案,患者肥胖或者肿瘤巨大或者部位特殊者,可以选择手辅助腹腔镜胃间质瘤切除术。

Objective To summarize the clinical experience in laparoscopic surgery for the treatment of gastric stromal tumor.Methods The clinical data of surgery procedures performed at the Gastrointestinal Ward of the PLA General Surgery Centre,General Hospitial of Chengdu Military Command from January 2006 to December 2010 for gastric stromal tumor were analyzed retrospectively.Results The gastric stromal tumors of 48 patients were resected completely,including laparoscopic surgery in 8,auxiliary laparoscopic surgery in 35,hand-assisted laparoscopic surgery in 5.There were a smooth postoperative recovery,and a postoperative hospitalization time of 6 ± 1.3 d,a follow-up of 3-45 months（mean 23 months）,loss of follow-up in 9 patients,good survival in the remaining patients.Conclusions Operation should be chosen according to the size and location of gastric stromal tumor.Hand-assisted laparoscopic surgery might be chosen for some special patients.