腹腔镜微创术治疗5～8 cm胃肠间质瘤的疗效及可行性分析

Efficacy and feasibility of laparoscopic minimally invasive surgery for 5～8 cm gastrointestinal stromal tumor

目的腹腔镜微创治疗5～8 cm胃肠间质瘤(GIST)的经验总结。方法回顾性分析我院行腹腔镜手术治疗(观察组)及开腹-手术治疗(对照组)的直径为5～8 cm GIST患者各48例临床资料。比较两组手术指标(包括手术时间、术中出血量、切口长度)和术后恢复情况(包括术后排气时间、术后进食时间、术后住院时间)差异,同时比较两组术后3个月内并发症发生情况,术后1年复发、转移、死亡情况及体力状况(东部肿瘤协作组织评分,ECOG)差异。结果观察组手术时间、术中出血量、切口长度、术后排气时间、术后进食时间、术后住院时间均明显低于对照组,差异均有统计学意义(P<0.05)。术后3个月内,两组并发症发生情况比较无显著性差异(P>0.05)。术后1年时,两组术后复发、转移及死亡情况及体力状况(ECOG评分)比较无显著性差异(P>0.05)。结论腹腔镜手术与开腹手术在直径5～8 cm GIST治疗中均有明显的近期疗效及安全性,而腹腔镜手术具有良好的微创优势,于促进患者术后恢复更有利。

Objective To explore the efficacy and feasibility of laparoscopic minimally invasivesurgery in the treatment of 5~8 cm gastrointestinal stromal tumor(GIST). Methods The clinical dataof each 48 patients with GIST of 5~8 cm diameter who underwent laparoscopic surgery(observation group)and laparotomy(control group)were retrospectively analyzed. The operation indexes(including operativetime,intraoperative blood loss,incision length)and postoperative recovery(including postoperativeexhaust time,postoperative feeding time,postoperative hospital stay)were compared between the twogroups. And the complications within three months after operation,recurrence,metastasis and death atone year after operation,and physical status[Eastern Cooperative Oncology Group Score(ECOG)]were also compared between the two groups. Results The operative time,intraoperative blood loss,incision length,postoperative exhaust time,postoperative feeding time and postoperative hospitalstay in observation group were significantly lower than those in control group(P<0.05). There was nosignificant difference in the occurrence of complications between the two groups within three months afteroperation(P>0.05). At one year after operation,there were no significant differences in recurrence,metastasis,and death status and physical status(ECOG score) between the two groups(P>0.05).Conclusion Laparoscopic surgery and laparotomy have significant short-term efficacy and safety in thetreatment of GIST with a diameter of 5~8 cm,and laparoscopic surgery has a good minimally invasiveadvantage and is more beneficial in promoting postoperative recovery.