双镜联合在胃肠间质瘤术中应用及其评价

Combined application of laparoscopy and endoscopy in the treatment of gastrointestinal stromal tumor

胃肠间质瘤(gastrointestinal stromal tumor,GIST)可以发生于消化道从食管到直肠的任何一个部位,是消化道最常见的间叶组织源性肿瘤。外科手术是GIST首选的治疗方式。单纯腹腔镜手术对于瘤体较小或未侵及浆膜面的胃间质瘤存在着术中定位不准的缺陷。近年来,双镜联合治疗GIST的理念已被越来越多的外科医师所接受。胃镜的优势在于能够较好的观察胃肠道黏膜面的情况并准确定位,在手术中还可以观察肿瘤是否被完整切除。当完成吻合后,还可以明确是否存在吻合口漏。对于瘤体较小的胃间质瘤,单纯内镜或单纯腹腔镜手术均难以达到理想效果,两者联合,则能在发挥各自优势的同时,弥补各自缺点。

Gastrointestinal stromal tumor （GIST） is the most common mesenchymal tumor of the gastrointestinal tract, which often requires a surgical removal. In the past, the risk of rupture of pseudocapsula and peritoneal dissemination have discouraged surgeons from making a minimally invasive surgical treatment. For Small stromal tumor, it is difficult for laparoscopy to locate. In recent years,the concept of minimally invasive surgery has been accepted by the surgical community. Though there are limitations in locating small GIST when laparoscopy is used alone. Meanwhile,endoscopy is an excellent tool for locating the small tumor. During laparoscopic operation,the endoscopy can help to locate the tumor. Endoscopy can also help to determine whether or not the tumor＆amp;nbsp;has been resected completely. And when operation finished, endoscopy can also check there is anastomotic leakage or not. In summary,the hybrid approach can not only decrease surgical incisions,but also avoid some of the surgical risks of operations.