腹腔镜联合胃镜治疗胃间质瘤45例

Laparoscopy Combined with Gastroscopy in Treatment for Gastric Stromal Tumors (Report of 45 Cases)

目的探讨腹腔镜与胃镜联合在切除胃间质瘤中的应用价值。方法回顾性分析我院2008年6月至2012年6月期间行腹腔镜联合胃镜治疗的45例胃间质瘤患者的临床资料。结果 45例患者均在腹腔镜与胃镜结合下成功切除胃间质瘤,肿瘤切除完整,边缘无残留。手术切口长约4～6cm(平均5.1cm),手术时间40～90min(平均75min),术后恢复顺利,未发生手术相关并发症,住院时间5～9d(平均6.8d)。随访3～24个月(平均16.5个月),未发生复发或转移。免疫组织化学检测结果:CD117阳性43例,CD34阳性32例,SMA阳性28例,Desmin阳性2例,S-100阳性22例。结论腹腔镜与胃镜结合治疗胃间质瘤,具有创伤小、手术时间短、术后恢复快等优点,同时由于有胃镜配合可以使切除范围更加精确,避免肿瘤残留及切除过多正常胃组织。

Objective To explore the value of laparoscopy combined with gastroscopy in treatment for gastric stromal tumors.Method The clinical data of 45 patients with gastric stromal tumors performed laparoscopy combined with gastroscopy resection from June 2008 to June 2012 in this hospital were analyzed retrospectively.Results Forty-five patients with gastric stromal tumors were successfully excised by laparoscopy combined with gastroscopy,and the tumors were completely resected and no residual tumor at the edge.The length of surgical incision was about 4-6 cm with an average of 5.1 cm.The mean operation time was 75 min.Postoperative recovery was smooth,no surgery-related complications occurred.The mean hospital stay was 6.8 d.No recurrence or metastasis happened within the follow-up with an average of 16.5 months.The immunohistochemical examination results：43 cases of CD117 was positive,32 cases of CD34 was positive,28 cases of SMA was positive,2 cases of Desmin was positive,22 cases of S-100 was positive.Conclusions The treatment of gastric stromal tumors through laparoscopy combined with gastroscopy is safe and effective.The benefits include minimal invasiveness,shorter operation time,and rapid postoperative recovery.The laparoscopy combined with gastroscopy can make more precise resection range,and avoid residual tumor and resection of excessive normal gastric tissue.