3D腹腔镜手术治疗胃底部间质瘤的临床疗效

Efficacy of 3D laparoscopic surgery in treatment of gastrointestinal stromal tumor in gastric fundus

目的:探讨3D腹腔镜手术治疗胃底部间质瘤的临床应用价值。方法:回顾性分析武汉大学人民医院2014年1月—2015年6月间收治的36例胃底部间质瘤患者临床资料,其中18例行3D腹腔镜手术(3D腔镜组),18例行开腹手术(开放手术组),比较两组患者的围手术期指标,术后病理资料及复发转移情况。结果:两组患者在年龄、性别、BMI、肿瘤大小等一般资料方面差异无统计学意义(均P>0.05)。两组手术时间差异无统计学意义(P>0.05),但3D腔镜组在术中出血量、手术切口长度、术后排气时间及住院天数等指标方面均明显优于开放手术组(均P<0.05)。两组患者均未出现肿瘤破裂以及切缘阳性的情况,均未发生大出血、吻合口瘘、术后肠梗阻等严重并发症,术后病理及免疫组化特征均无明显差异(均P>0.05)。所有患者随访12~36个月,无复发、转移及死亡病例。结论:应用3D腹腔镜技术治疗胃底部间质瘤,能明显减少患者的手术创伤,且远期疗效与开放手术相似。

Objective： To assess the clinical application value of 3D laparoscopic surgery in treatment of gastrointestinal stromal tumor in the fundus of the stomach.Methods： The clinical data of 36 patients with gastrointestinal stromal tumor in gastric fundus treated between January 2014 and June 2015 in Renmin Hospital of Wuhan University were retrospectively analyzed. Of the patients, 18 cases underwent 3D laparoscopic resection （3D laparoscopic group） and 18 cases were subjected to open resection （open surgery group）. The perioperative variables and postoperative pathological results as well as recurrence and metastasis were compared between the two groups of patients.Results： There were no differences between the two groups in terms of general data such as age, gender, tumor size and BMI （allP〉0.05）. No statistical difference in operative time was noted between the two groups, while the indices such as intraoperative blood loss, length of the incision, time to postoperative gas passage and length of hospital stay in 3D laparoscopic group were significantly better than those in open surgery group （allP〈0.05）. No tumor rupture or positive margin was found and no severe complications such as massive hemorrhage, anastomotic fistula and postoperative intestinal obstruction occurred in either group, and the postoperative pathological and immunohistochemical features of the two groups showed no significant difference （allP〈0.05）. All patients were followed up for 12 to 36 months, and no cases of tumor metastasis and recurrence or death occurred.Conclusion： Using 3D laparoscopic technique in treatment of gastrointestinal stromal tumor in the gastric fundus can significantly minimize the surgical trauma of the patients, and its long-term efficacy is similar to that of open resection.