腹腔镜下胃肠间质瘤切除术单中心回顾性分析

Single-center retrospective analysis of laparoscopic resection of gastrointestinal stromal tumor

目的探究腹腔镜下胃肠间质瘤(GIST)切除术的临床疗效及安全性。方法回顾性分析2014年3月至2017年7月实施GIST切除术的80例患者资料,根据术式不同分为腹腔镜组(62例)和开腹组(18例)。采用统计软件SPSS21.0行数据分析,围术期指标采用(x±s)表示,独立样本t检验;术后并发症发生率行χ2检验。采用Kaplan-Meier法进行预后生存分析,P<0.05为检验标准。结果腹腔镜组在手术时间、出血量、术后恢复等方面优于开腹组(P<0.05)。两组术后并发症总发生率、术后20个月无病生存率及总生存率差异无统计学意义(P>0.05)。组织病理检查结果显示,胃肠间质瘤病灶形态多为椭圆形、类圆形及不规则形,其中梭形细胞型占比最多(71.3%)。免疫组织化学检测显示,CD34蛋白阳性率为83.7%,CD117蛋白阳性率为95.0%,DOG1蛋白阳性率为91.3%。结论腹腔镜下GIST切除术较传统开腹手术术时短、出血少、恢复快、并发症少,手术安全可行,值得推广应用。

Objective To explore the efficacy and safety of laparoscopic resection of gastrointestinal stromal tumor.Methods Data of 80 patients who underwent gastrointestinal stromal tumor resection from March 2014 to July 2017 were retrospectively analyzed,they were divided into laparoscopic group(62 cases)and laparotomy group(18 cases)according to different surgical methods.Statistical software SPSS21.0 was used for data analysis,perioperative indicators were represented by(x±s),and independent sample t test was used.The incidence of postoperative complications was compared byχ2.Kaplan-meier method was used for prognosis and survival analysis,with P<0.05 as the test standard.Results The laparoscopic group was better than the laparotomy group in terms of operation time,blood loss and postoperative recovery(P<0.05).There was no significant difference in the overall incidence of postoperative complications,disease-free survival rate at 20 months after surgery and overall survival rate between the two groups(P>0.05).Histopathological examination showed that the lesions of gastrointestinal stromal tumor were mostly oval,almost round and irregular,among which spindle cell type accounted for the largest proportion(71.3%).Immunohistochemistry showed that the positive rate of CD34 protein was 83.7%,that of CD117 protein was 95.0%,and that of DOG1 protein was 91.3%.Conclusion Laparoscopic resection of gastrointestinal stromal tumor is shorter,less bleeding,faster recovery and less complications than traditional laparotomy.