腹腔镜联合胃镜治疗早期胃间质瘤的疗效观察

Effect and Follow-up Observation of Gastroscopy and Laparoscopy in the Treatment of Early Gastrointestinal Stromal Tumors

目的:探讨腹腔镜联合胃镜治疗早期胃间质瘤的疗效。方法:将入院收治的60例早期胃间质瘤患者,根据随机数字表法,分为治疗组和对照组各30例,分别采用腹腔镜联合胃镜切除术、开腹切除术。比较两组手术指标、术后恢复情况、并发症及局部复发转移情况。结果:与对照组比较,治疗组手术时间明显延长,而肿瘤定位时间、术中出血量、肠鸣音恢复时间明显减少(P<0.05)。治疗组术后总并发症发生率明显低于对照组(P<0.05)。随访期间,两组均无死亡病例,治疗组和对照组局部复发转移率分别为16.7%、13.3%(P>0.05);治疗组局部复发转移的平均时间为(47.7±6.18)个月,对照组局部复发转移的平均时间为(48.8±7.14)个月,差异无统计学意义(P>0.05)。结论:腹腔镜联合胃镜下行早期胃间质瘤肿瘤切除在肿瘤根治性、远期预后等方面与开腹手术相当,但可提高手术定位准确性,减少术后并发症,促进胃肠道功能恢复。

Objective To explore the effect of gastroscopy and laparoscopy in the treatment of early gastrointestinal stromal tumors（GIST）.Methods According to the random number table, 60 cases with early GIST were divided into two groups.The patients in treatment group（n=30） and control group（n=30） were given gastroscopy-assisted laparoscopic resection and open surgery, respectively.The operation related indexes, postoperative recovery, complications and local recurrence and metastasis in two groups were recorded.Results Compared with the control group, the operation time was significantly increased, the lesion location time, intraoperative blood loss and peristaltic sounds recovery time in treatment group were decreased（P〈0.05）.The total incidence of complications in treatment group was significant lower than that of control group（P〈0.05）.During follow-up, there were no deaths in both groups, the local recurrence and metastasis rate in treatment group and control group was 16.7% and 13.3%, respectively（P〉0.05）.There was no significant difference on the average time of recurrence and metastasis after surgery between two groups [（47.7±6.18）months vs（48.8±7.14） months, P〉0.05].Conclusion Gastroscopy-assisted laparoscopic resection for the treatment of early gastric stromal tumors has similar effect on the oncologic clearance and long-term prognosis with open surgery, and can improve the positioning accuracy, reduce postoperative complications, and promote recovery of gastrointestinal function.