胃镜辅助在腹腔镜胃间质瘤切除术中的应用体会

The application of gastroscopic-assisted laparoscopic resection of gastric stromal tumor

目的:探讨胃镜辅助在腹腔镜胃间质瘤切除术中的应用价值。方法:回顾分析2013年2月至2017年6月35例胃镜辅助腹腔镜胃间质瘤切除术(研究组)与35例开腹胃间质瘤切除术(对照组)患者的临床资料,比较两组手术及病理相关资料。结果:研究组与对照组手术时间[(85.94±14.20)min vs.(86.66±13.60)min,P=0.830]、术后并发症发生率(5.7%vs.11.4%,P=0.669)差异无统计学意义,研究组与对照组术中出血量[(32.71±17.75)ml vs.(43.43±22.65)ml,P=0.031]、术后肛门排气时间[(2.50±0.56)d vs.(3.30±0.55)d,P=0.000]、术后住院时间[(6.91±0.70)d vs.(8.60±0.70)d,P=0.000]差异有统计学意义。两组中位随访时间分别为27个月与31个月,研究组中1例高危患者发现肝转移,对照组中1例高危患者肝转移、1例腹腔转移。结论:对于直径≤5 cm的胃间质瘤,胃镜辅助腹腔镜手术具有创伤小、术中出血少、术后康复快等优点,值得临床推广。

Objective：To explore the value of gastroscope-assisted laparoscopic technique in the resection of gastric stromal tumor. Methods ：The clinical data of 35 patients who suffered from gastric stromal tumor and underwent gastroscopic assisted laparo-scopic resection （research group） and 35 patients of gastric stromal tumor who underwent open resection （control group） from Feb. 2013 to Jun. 2017 were retrospectively analyzed,the operative and pathological data were compared between the two groups. Results： Compared with the control group, the research group showed no significant difference in operation time [ （85.94 ± 14.2 ） rain vs. （86.66 ± 13.6） min,P =0. 830] or postoperative eoroplications （5.7% vs. 11.4% ,P =0.669）. The amount of the bleeding volume [ （ 32.71 ± 17.75 ） ml vs. （43.43 ± 22.65 ） ml,P = 0. 031], postoperative anal exhaust time [ （2.50 ± 0, 56 ） d vs. （ 3.30 ± 0. 55 ） d, P = 0. 000 ] ,postoperative hospital stay [ （6.91 ± 0. 70） d vs. （ 8.60 ± 0. 70） d, P = 0. 000 ] between the research group and control group were statistically significantly different. Median follow up time in the research group and the control group was 27 months and 31 months respectively,in patients of high risk, one hepatic metastasis was found in the research group,one hepatic metastasis and one ab- dominal metastasis were found in the control group. Conclusions ： Gastroseopie-assisted laparoseopic surgery has advantages of few trau-ma,little intraoperative bleeding, quick postoperative recovery in the treatment of gastric stromal tumors less than or equal to 5 cm,and is worthy to be popularized in Clinic.