探讨腹腔镜联合胃镜在胃间质瘤手术中的临床应用

Discussion on the clinical application of laparoscope combined gastroscope in gastric stromal tumor surgery

目的通过对比腹腔镜联合胃镜与开腹手术治疗胃间质瘤的临床效果,分析腹腔镜联合胃镜的临床应用价值。方法选取2011年1月至2015年12月期间在我院手术治疗的胃间质瘤患者60例作为研究对象,根据手术方式的不同分为实验组和对照组,对照组患者采取开腹手术进行治疗,实验组患者采取腹腔镜联合胃镜进行治疗,观察并对比两组患者手术治疗过程中的各项指标、术后并发症的发生率以及复发率等。结果实验组患者的手术时间略低于对照组患者,但差异没有统计学意义(P>0.05)。实验组患者的术中出血量、排气时间、饮食恢复时间以及住院时间等明显小于对照组患者,差异均具有统计学意义(P<0.05)。实验组患者术后发生1例吻合口渗血,并发症的发生率为2.9%;对照组患者术后发生1例吻合口渗血、1例切口感染、1例轻度肺感染、1例粘连性肠梗阻,并发症的发生率为15.4%,两组患者的并发症发生率比较差异具有统计学意义(P<0.05)。实验组患者术后无1例复发,对照组患者术后复发1例,两组患者复发率比较无明显差异(P>0.05)。结论腹腔镜联合胃镜治疗胃间质瘤疗效显著,并发症的发生率低,不易复发,具有一定的临床应用价值。

Objective To analyze the clinical application value of laparoscope combined gastroscope,by comparing the clinical effect of laparoscope combined gastroscope and laparotomy in the treatment of gastric stromal tumor. Methods 60 cases with gastric stromal tumor,which admitted in our hospital during January 2011 and December 2015,were selected as the research object and divided into the experimental group and the control group according to the different operation mode. The control group was given the laparotomy for the treatment,while the experimental group was given the laparoscope combined gastroscope for the treatment. The indicators in the process of surgical treatment,the incidence of postoperative complications and recurrence rate of the two groups were compared and analyzed. Results The operation time of the experimental group was slightly lower than the control group,while there was no statistically significant difference（ P〉0. 05）. The intraoperative blood loss,exhaust time,diet recovery time and hospital stay of the experimental group was less than the control group,the differences were statistically significant（ P〈0. 05）. 1 case postoperative anastomotic bleeding occurred in experimental group,the incidence rate of complications was 2. 9%. In control group occurred there were 1 case postoperatively anastomotic bleeding,1 case of incision infection,1 case of mild pulmonary infection,1 case of adhesive intestinal obstruction,the incidence rate of complications was 15. 4%,the difference was statistically significant（ P〈0. 05）. There was none recurrence in experimental group after operation,but the control group with 1 case,there was no statistically significant difference between the two groups（ P〉0. 05）. Conclusions Laparoscopy combined endoscopy in the treatment of gastric stromal tumor has significantly curative effect,the incidence of complications is low,not easy to relapse,which has certain clinical application value.