完全腹腔镜胃腔内手术治疗胃黏膜下肿瘤的应用体会

Application of complete laparoscopic intragastric surgery for gastric submucosal tumors

目的:评估完全腹腔镜胃腔内胃手术治疗胃黏膜下肿瘤的可行性、安全性及临床应用价值。方法:回顾分析2017年9月至2018年12月为15例胃黏膜下肿瘤患者行完全腹腔镜胃腔内手术切除术的临床资料。结果:15例手术均顺利完成,术中术野稳定、清晰,无一例需要内镜干预,术后病理报告示切缘阴性。中位手术时间64(48~92)min,中位失血量25(5~80)mL,术后中位住院时间4(2~5)d。术后1例患者发现经胃管出血,经对症治疗后治愈。术后随访12个月,无局部复发病例,无一例发生胃出血、胃瘘、胃穿孔等相关并发症。结论:利用专用腹腔镜装置施行完全腹腔镜胃内手术安全、可行,经济实惠,临床应用价值较高。

Objective:To evaluate the feasibility,safety and clinical value of totally laparoscopic intragastric surgery for gastric submucosal tumors.Methods:The clinical data of 15 patients who underwent totally laparoscopic intragastric surgical resection of gastric submucosal tumors from Sep.2017 to Dec.2018 were retrospectively analyzed.Results:All 15 operations were successfully completed without taking any intervention.The postoperative pathology indicated negative resection margins.The median operation time was 64(48-92)minutes,the median blood loss was 20(5-80)mL,and the median hospital stay was 4(2-5)days after surgery.One patient was diagnosed with gastrointestinal bleeding after surgery and was cured.The patients were followed up for 12 months.There were no cases of local recurrence,and no related gastric bleeding,gastric fistula,or gastric perforation occurred.Conclusions:The totally laparoscopic intragastric operation is safe,feasible,economical,and highly valuable in clinical application to be performed using this specific device.