内镜切除治疗巨大胃间质瘤的临床效果及安全性分析

The analysis of the effectiveness and safety of endoscopic resection for huge gastric stromal tumor

目的分析内镜切除治疗无明确转移的胃巨大问质瘤的临床效果和安全性。方法胃巨大间质瘤患者90例,根据治疗方式不同分为内镜治疗组、开腹手术组及腹腔镜手术组,其中内镜组25例,开腹手术组34例,腹腔镜手术组31例。观察3组的术中出血、穿孔发生情况、整块切除率和随访结果,比较3组患者的手术时间、住院时间和住院费用。结果内镜组成功23例,切除率92.0%,平均手术时间(61.37±15.34)分钟,住院时间(5.74±1.44)天,均显著短于开腹手术组[(117.68±29.42)分钟,(12.16±3.04)天]和腹腔镜手术组[(100.26±25.07)分钟,(9.38±2.35)天];平均治疗总费用(22839.26±5709.82)元,显著少于开腹手术组[(31017.62±7754.41)元],差异有统计学意义(P<0.05);3组患者术后随访均未发现严重的并发症,无死亡病例。结论内镜切除治疗无明确转移的胃巨大间质瘤,安全可行,手术时间和住院时间短,治疗费用较少。

Objective To analyze the effectiveness and safety of endoscopic resection for huge gastric stromal tumor（GIST） with no metastasis. Methods A total of 90 cases of huge GST were retro- spectively analyzed according to the treatment, including 25 cases of endoscopic resection ,34 cases of laparotomy and 31 cases of laparoscopic resection. The operation time, hospital stay and medical expense of the three groups were statistically compared and analyzed. The feasibility and safety of endoscopic resec- tion were assessed according to the intraoperative blood loss, perforation, en bloc resection rate and follow- up results. Results in the 25 cases,23 cases of endoscopic resection succeeded, with a removal rate of 92.00% ;the average operation time [ （61.37 ± 15.34） min] and hospital stay [ （5.74 ± 1.44） d] for the group of patients with endoscopic resection were significantly shorter than the open surgery group [ （ 117.68 ± 29.42） rain and （ 12.16 ± 3.04 ） d ] and laparoscopic surgery group [ （ 100.26 ±25.07 ） min and（9.38±2.35） d]. The average cost of endoscopic resection [ （22839.26 ±5709.82） yuan] was significantly lower than the open surgery group [ （ 31017.62 ±7754.41 ） yuan] with a statistically significant difference （ P 〈 0.05 ） ; all three groups of patients were followed up and there were no serious complications or death. Conclusion The endoscopic resection for huge GST with no metastasis is safe and feasible with shorter operation time and hospital day and less cost of treatment.