腹腔镜与开放手术治疗胃肠间质瘤术后并发症和远期肿瘤学疗效对比

Comparison of postoperative complications and long-term oncology efficacy in laparoscopic versus open surgery on gastrointestinal stromal tumors

目的 比较腹腔镜和开放手术治疗胃肠间质瘤术后并发症和远期肿瘤学的疗效.方法 选择2013年2月至2014年10月胃肠间质瘤患者98例,按照随机、对照原则将其分为两组,每组49例.对照组接受传统开放手术,观察组接受腹腔镜下肿瘤切除术.比较两组手术前后T淋巴细胞因子水平变化及远期复发率.结果 观察组中出血量、排气时间及住院时间优于对照组,差异有统计学意义（P〈0.05）.观察组术后不同时期CD3、CD4、CD4/CD8水平高于对照组,CD8水平低于对照组,差异有统计学意义（P〈0.05）.随访24个月,两组患者生存率及复发率比较差异未见统计学意义（P〉0.05）.结论 采用腹腔镜手术治疗胃肠间质瘤,同开放手术在患者远期复发率及生存率方面并无明显差异,但腹腔镜手术可有效降低手术创伤性刺激,促进患者术后机体免疫功能的恢复.

Objective To investigate the effects of laparoscopic surgery and open surgery on the incidence of complications and long-term oncologic treatment of gastrointestinal stromal tumors.Methods From February 2013 to October 2014, 98 patients with gastrointestinal stromal tumor were selected, and were divided into the two groups according to the principle of randomization, with 49 cases in each group.The control group was treated by traditional open surgery, and the observation group was given aparoscopic resection of the tumor.The changes of the T lymphocyte factor before and after operation and the long-term recurrence rate were observed and analyzed.Results The bleeding volume, exhaust time and hospital stay in the observation group were higher than those in the control group （P〈0.05）.The levels of CD3, CD4, CD4/CD8 in the observation group were higher than those in the control group at different time after operation, and the level of CD8 was lower than those of the control group （P〈0.05）.The survival rate and recurrence rate were compared between the two groups, the differences were not significant （P〉0.05）.Conclusions Laparoscopic surgery for gastrointestinal stromal tumors, with open surgery in patients with long-term recurrence rate and survival rate is not significantly different, but laparoscopic surgery can effectively reduce traumatic stimulation, and can promote the recovery of patients with postoperative immune function.