腹腔镜胃间质瘤切除术手工缝合胃创面30例报告

Laparoscopic resection of gastric stromal tumors and manual suturing gastric stump: a report of 30 cases

目的：探讨腹腔镜胃间质瘤切除术后手工缝合胃壁的临床效果。方法：回顾分析2011年1月至2013年12月为30例胃原发间质瘤患者行腹腔镜手工缝合手术的临床资料。6例患者肿瘤直径≤2.0 cm,19例为2.1~5.0 cm,5例〉5.0 cm。肿瘤位于贲门部2例、胃底8例、胃体前壁4例、胃体后壁5例、胃窦前壁5例、胃窦后壁2例、胃小弯侧4例。结果：30例手术均获成功。手术时间平均（90.0±20.37）min,术中出血量平均（15.0±12.85）ml;术后肠道功能恢复时间平均（36.0±9.44）h,术后恢复进食时间平均（3.0±1.21）d,无出血、胃瘘、腹腔感染等并发症发生。术后平均住院（8.0±1.61）d。术后随访6~12个月,无肿瘤复发及转移。结论：腹腔镜下采用手工缝合的方法治疗胃间质瘤体现了腹腔镜手术的优点。对于特殊部位的间质瘤可行腹腔镜手术。

Objective： To investigate the therapeutic experience of manual suturing gastric stump under laparoscopy after the resection of gastric stromal tumors. Methods： A retrospective analysis was made on the clinical data of 30 patients between Jan. 2011 and Dec. 2013 who underwent the manual suturing gastric stump under laparoscopy to treat the gastric stromal tumors. There were 6 cases with tumor size no more than 2 cm,19 cases with tumor size between 2. 1 cm and 5 cm,and 5 cases with tumor size greater than 5 cm.In terms of tumor position,there were 2 cases around cardia,8 cases around gastric fundus,4 cases around anterior gastricus,5 cases around posterior gastricus,5 cases around anterior antrum,2 cases around posterior antrum,4 cases around lesser gastric curvature. Results： Thirty surgeries were all successful. The average duration of surgery was（ 90. 0 ± 20. 37） min. The amount of bleeding was（ 15. 0± 12. 85） ml. The average bowel function recovery time was（ 36. 0 ± 9. 44） h. The average time for resuming eating after surgery was（ 3. 0 ± 1. 21） d. No bleeding,gastric fistula or intra-abdominal infection was found. Postoperative hospital stay was（ 8. 0 ± 1. 61） d.Patients were followed up for 6-12 months,no tumor relapse or metastasis was found. Conclusions： The manual suturing gastric stump under laparoscopy after the resection of gastric stromal tumors shares the common advantages as other surgeries under laparoscopy. Some gastric stromal tumors at special position could be treated by this method as well.