双镜联合治疗胃间质瘤的效果分析

Analysis of the effect of combined therapy by two scopes in the treatment of gastric stromal tumors

目的 探讨腹腔镜联合胃镜在胃间质瘤手术治疗中的临床效果。方法 回顾分析2011年1月-2013年11月在包头市肿瘤医院治疗的胃间质瘤的患者44例。患者按采用的手术切除方式分为两组：1传统的开腹切除手术16例（男11例,女5例）——传统开腹组;2腹腔镜联合胃镜方式切除28例（男18例,女10例）——双镜联合组。收集患者的临床和病理资料,建立患者个人档案。1年后进行术后随访,综合比对两组患者的手术恢复情况、胃功能恢复情况、身体机能恢复情况、住院天数及伤口愈合时间等。结果 传统开腹组16例手术均顺利完成,双镜联合组1例因位置不佳中转开腹,其余27例手术顺利完成。双镜联合组在手术时间、术中出血量、术后并发症、进食时间以及住院天数方面均明显优于传统开腹组（P〈0.05）;双镜联合组术后并发症发生率低于传统开腹组（P〈0.05）,肿瘤转移率高于传统开腹组,差异无统计学意义（P〉0.05）。结论 腹腔镜联合胃镜治疗胃间质瘤具有快速定位、创伤小、恢复快等优点,但对肿瘤细胞的清除效果劣于传统开腹手术。

Objective To investigate the clinical effect of laparoscopy combined with gastroscopy in the treatment of gastric stromal tumors. Methods A total of 44 patients with gastric stromal tumors who were treated in Baotou Cancer Hospital from January 2011 to November 2013 were retrospectively analyzed. Patients were divided into two groups according to the surgical methods： 1The traditional laparotomy was performed in 16 patients（11 males and 5 females）-traditional laparotomy group; 2Laparoscopy combined with gastroscopy was performed in 28 patients（18 males and 10females）-combined two scopes group. Patients＇ clinical and pathological data were collected and patients＇ profiles were created. Postoperative follow-up was carried out one year later. The effects of the two group on the patient＇s recovery,gastric function recovery, recovery of physical function, length of stays and wound healing time were comprehensively compared. Results 16 cases in the traditional laparoscopy group were successfully completed. 1 case in the combined group was converted to laparotomy due to poor location. The remaining 27 cases were successfully completed. The surgery time, intraoperative blood loss, postoperative complications, eating time and length of stays were significantly better in the combined group than in the traditional laparotomy group（P〈0.05）; the rate of complications was lower in the combined group than in the traditional laparotomy group（P〈0.05）. The tumor metastasis rate was higher than that in the traditional laparotomy group, but there was no significant difference（P〈0.05）. Conclusion Laparoscopy combined with gastroscopy in the treatment of gastric stromal tumor has the advantages of rapid localization, less trauma and faster recovery, but its effect on tumor cell removal is inferior to the traditional laparotomy.