不同微创术治疗胃间质瘤的临床效果

Clinical Effect of Different Minimally Invasive Procedures in the Treatment of Gastric Stromal Tumors

目的探讨不同微创术治疗胃间质瘤的临床效果及预后。方法收集宝鸡高新人民医院、西安交大第一附属医院及陕西省第四人民医院接受手术治疗的61例胃间质瘤患者病例资料,进行回顾性分析,根据手术方式分为双镜组(腹腔镜联合胃镜,n=21),腹腔镜组(n=20),胃镜组(n=20),比较3组术中、术后情况及预后,随访1~5年,统计3组近远期生存情况。结果经统计,3组在性别、年龄、肿瘤位置分布均无统计学差异(P> 0. 05),但双镜联合组、腹腔镜组肿瘤直径明显大于胃镜组(P <0. 05)。腹腔镜组的手术时间、术中出血量、术后住院时间均明显高于胃镜组、双镜联合组(P <0. 05),而其中双镜联合组明显高于胃镜组(P <0. 05)。另外3组的肿瘤组织学定位分布相比,存在显著差异(P <0. 05)。同时3组环周切缘均为阴性,且3组NIH分级相比,差异无统计学意义(P> 0. 05)。随访1~6年,3组均无死亡病例,无转移病例。结论对于≤5. 5 cm的胃间质瘤,需根据肿瘤大小、位置及组织学定位等,具体分析,制定适合患者病情的手术方案。

Objective To explore the clinical effect and prognosis of different minimally invasive procedures in the treatment of gastric stromal tumors. Methods 61 cases of gastric stromal tumors( GIST) patients who received surgical treatment were collected and analyzed retrospectively. According to the operation mode,the patients were divided into 2 groups: laparoscope combined with gastroscopy group,laparoscopy group and gastroscopy group. To compare the intraoperative,postoperative and prognosis of the 3 groups,followed up for 1 ~ 5 years,and the survival of the 3 groups in the near and long term were counted. Results There were no statistical difference in the distribution of sex,age and tumor location among the 3 groups( P > 0. 05),but the diameter of tumor in the 2 groups was significantly larger than that of the gastroscopic group( P < 0. 05). The operative time,intraoperative bleeding volume and postoperative hospitalization time in the laparoscopy group were significantly higher than those of the gastroscopy group,and the laparoscope combined with gastroscopy was significantly higher than that of the gastroscope group( P < 0. 05),and thelaparoscope combined with gastroscopy was significantly higher than the gastroscope group( P < 0. 05). In the other three groups,there was a significant difference in the distribution of tumor histological localization( P < 0. 05). At the same time,the circumferential margin of the three groups were negative,and there were no significant difference between the three groups in NIH grade( P > 0. 05). There were no death cases and no metastasis cases in the 3 groups. Conclusion In case of gastric stromal tumor ≤5. 5 cm,the operative plan suitable for patient’s condition should be made according to the size,location and histological localization of the tumor.