腹腔镜手术治疗胃间质瘤的临床研究

Clinical research of laparoscopic surgery for gastric GIST

目的:探讨腹腔镜技术在胃间质瘤手术治疗中的临床应用价值。方法:回顾性分析2004年6月至2011年1月我院行腹腔镜胃间质瘤切除术68例病人的临床资料。包括手术时间、术中出血量、术后排气时间、术后住院天数、并发症、术后病理和随访等。结果:本组研究68例病人中,均在腹腔镜下顺利完成手术。腹腔镜胃楔形切除术34例(50%),腹腔镜经胃肿瘤外翻切除术32例(47.1%),腹腔镜辅助远端胃大部切除术1例(1.47%),腹腔镜辅助近端胃大部切除术1例(1.47%)。瘤体平均直径(3.2±1.6)cm,手术平均时间(83.0±27.5)min,术后平均出血量(29.0±23.7)mL,术后平均住院天数(7.5±1.4)d。并发症3例(4.4%),随访63例(92.6%),中位随访时间27个月,63例均无复发及远处转移,1例术后其他原因死亡。总生存率98.5%。结论:腹腔镜手术是治疗胃GIST安全、微创、有效的方法。

Objective To investigate the clinical value of laparoscopic resection of gastric GIST.Methods From Jun 2004 to Jan 2011,68 patients with gastric GIST underwent laparoscopic gastric resection,they were retrospectively reviewed and analyzed with the surgical procedure,operative time,blood loss,time for passage of flatus,post-operative hospital stay,complications,pathology and follow-up.Results All patients underwent laparoscopic gastric resection successfully.Thirty-four patients（50%） subjected to laparoscopic wedge resection（LWR）,32（47.1%） laparoscopic transgastric tumor everting resection（LTGTER）,1（1.47%） laparoscopy-assisted distal gastrectomy（LADG） and 1（1.47%） laparoscopy-assisted proximal gastrectomy（LAPG）.The mean operative time was（83.0±27.5） min,quantity of blood loss was（29.0±23.7） mL and the post-operative hospital stay was（7.5±1.5） days.Except 2 patients（3.0%） with anastomostic bleeding and 1 patient（1.5%） with gastroparesis,no operative complication occurred.The resection margin of the tumor was microscopically negative and the mean size of the tumor was（3.2±1.6） cm.After 27 months of follow-up,there was no recurrence or metastasis.Conclusions Laparoscopic resection is safe,minimal invasive,effective for gastric GIST.