胃间质瘤的双镜联合微创与开腹手术的对比研究

A Comparative study between laparoscopy combined with gastroscopy minimally invasive surgery and open surgery in treating gastric stromal tumors

目的探讨腹腔镜与胃镜双镜联合微创手术治疗胃间质瘤的临床效果、安全性及可行性。方法回顾性分析我院同一手术团队2009年3月至2013年3月施行46例早期胃间质瘤手术治疗患者的临床资料,腹腔镜与胃镜联合微创手术组（双镜联合组）24例,开腹手术组（对照组）22例。比较两组的术中情况、术后恢复情况及随访结果。结果与开腹手术组比较,双镜联合组手术时间短[（79.71±24.34）min vs（101.09±26.48）min,t=-2.854,P=0.007],术中出血量少[（35.42±17.00）ml vs（85.23±43.30）ml,t=-5.051,P=0.000],术后住院时间短[（6.04±1.78）d vs（10.00±3.12）d,t=-5.226,P=0.000],术后排气时间早[（23.92±5.66）h vs（49.27±17.14）h,t=-6.615,P=0.000]。两组均无术中、术后严重并发症和手术死亡病例。随访5~48个月,均无复发及转移。结论双镜联合微创手术与开腹手术治疗早期胃间质瘤相比是可行、安全和有效的。

Objective To evaluate the clinical efficacy,security and feasibility of laparoscopy combined with gastroscopy for treating gastric stromal tumors. Methods Retrospectively analyzed the datas of 46 patients with early gastric stromal tumors and they received surgery operated by the same team during March 2009 and March 2013. Among them,24 patients received the treatment of laparoscopy combined with gastroscopy（ combination group）,22 patients underwent open surgery（ control group）. The intra- operative and postoperative situation and follow- up results of these patients were compared. Results Operation time of combination group（ 79. 71 ± 24. 34min） shorter than that of control group（ 101. 09 ± 26. 48min）（ t =- 2. 854,P= 0. 007）. The intra- operative blood loss of combination group（ 35. 42 ± 17. 00ml） was less than that of control group（ 85. 23 ± 43. 30ml）（ t =- 5. 051,P = 0. 000）. Postoperative hospital stay of combination group was less than that of control group（ 6. 04 ± 1. 78d versus 10. 00 ± 3. 12d,t =- 5. 226,P = 0. 000）,so did the first postoperative flatus（ 23. 92 ± 5. 66h versus49. 27 ± 17. 14h,t =- 6. 615,P = 0. 000）. None serious intraoperative and postoperativecomplications and death occurred in both groups. None recurrence or metastasis was found during the follow- up period from 5 to 48 months. Conclusions Compared to open surgery,laparoscopy combined with gastroscopy minimally invasive surgery is feasible,safe and effective for treating early gastric stromal tumors.