腹腔镜联合胃镜治疗胃间质瘤的临床应用

Clinical application of laparoscopy plus endoscopy in the treatment of gastric stromal tumor

目的：探讨腹腔镜联合胃镜治疗胃间质瘤的可行性和临床价值。方法对2011年6月至2013年6月间接受双镜联合手术治疗的30例胃间质瘤病人的临床资料进行回顾性分析。30例胃间质瘤病人中男性16例,女性14例,年龄40～70岁,18例有上消化道不适,2例有上消化道出血症状,其余10例为体检发现,无明显症状、体征,胃镜检查示黏膜下隆起；超声胃镜示病灶处呈低回声或强回声,边界清楚,内部回声均匀,位于黏膜下层或固有肌层。术前所有病例均行超声胃镜和CT 检查报告提示胃间质瘤,其中20例位于胃体前壁,6例位于胃体后壁大弯侧,4例位于胃底小弯侧,直径1.5～3.0 cm,边界清楚。结果手术均获成功,无中转开腹和手术死亡病例。手术时间（60±15）min,术中出血量（30±10）ml,术后胃肠功能恢复时间（24±8）h,术后住院（5±2）d,无术后并发症出现,随访12～36个月,未见肿瘤复发和远处转移。结论腹腔镜联合胃镜治疗胃间质瘤是安全可行、具有微创、恢复快的特点,疗效满意。

Objective To evaluate the feasibility and clinical value of laparoscopy plus endosco-py in the treatment of gastric gastrointestinal stromal tumor （GIST）.Methods Retrospective analyses were performed for the clinical data of 30 patients undergoing laparoscopy plus endoscopy for gastric GIST between June 201 1 and June 2013.Results All operations were successful.There was neither conversion nor mortality.The mean operative duration was （60±1 5）min,mean blood loss （30± 10）ml,mean postoperative gastrointestinal functional recovery time （24±8）h and mean postoperative hospital stay （5±2）days.No postoperative complications occurred.There was no onset of recur-rence or metastasis during a follow-up period of 12-36 months.Conclusions Laparoscopy plus endoscopy is safe,feasible and mini-invasive for gastric GIST with rapid recovery and satisfactory outcomes.