腹腔镜联合电子胃镜手术治疗胃间质瘤的疗效观察

Observation on the curative effect of laparoscopy combined with electronic gastroscopy in the treatment of gastric stromal tumor

目的探讨腹腔镜联合电子胃镜手术治疗胃间质瘤(gastric stromal tumors,GST)的安全性及可行性。方法对2018年8月至2019年11月于兰州大学第一医院东岗院区应用电子胃镜定位后行腹腔镜下胃腔外肿瘤楔形切除术的8例GST住院患者的临床资料进行回顾性分析,包括患者术中、术后及随访情况。结果8例GST患者经电子胃镜定位后在腹腔镜下行胃腔外肿瘤楔形切除术,均成功切除病灶,术中无中转开腹及术后死亡。手术时间(71.6±9.8)min,术中出血量(35.0±10.8)ml,术后胃肠道功能恢复时间(2.8±0.7)d,术后下床活动时间(1.0±0.4)d,进半流质食物时间(2.7±0.5)d,术后住院时间(6.8±1.7)d。8例患者术后均未发生吻合口出血、吻合口瘘、吻合口狭窄、切口感染、肠梗阻、泌尿系感染及肺部感染等并发症,且术后切除标本病理检查证实为GST,切缘均未见肿瘤组织。8例患者术后均随访6个月,所有随访病例经计算机断层扫描、电子超声胃镜检查均未发现肿瘤复发和转移。结论腹腔镜联合电子胃镜手术治疗GST具有定位准确、手术时间短、术中出血少、并发症低等优点,是一种安全、可行、精准、微创的手术方法。

Objective To explore the safety and feasibility of laparoscopic combined with endoscopic sinus surgery for gastric stromal tumors(GST).Method The clinical data of 8 cases of GST hospitalized patients undergoing laparoscopic extracranial tumor wedge resection after application of the electronic gastroscope positioning were retrospectively analyzed from August 2018 to November 2019 in the Donggang Branch of the First Hospital of Lanzhou University.Result 8 patients with GST were treated with laparoscopic tumor outside the gastric cavity wedge resection after electronic gastroscope positioning and the operation was successfully completed without metastatic laparotomy and intraoperative death.The operation time(71.6±9.8)min,intraoperative blood loss(35.0±10.8)ml,postoperative gastrointestinal function recovery time(2.8±0.7)d,postoperative bedtime(1.0±0.4)d,Time for feeding semi liquid food(2.7±0.5)d,and postoperative hospital stay(6.8±1.7)d.8 patients had no anastomotic bleeding,anastomotic fistula,anastomotic stenosis,incision infection,intestinal obstruction,urinary tract infection and pulmonary infection and other complications,and pathological biopsy confirmed GST,margin were not seen tumor organization.8 patients were followed up for 6 months.All follow-up cases were examined by computed tomography and electron microscopy,no recurrence and metastasis were observed.Conclusion Laparoscopic combined with endoscopic sinus surgery for the treatment of GST is a safe and feasible precision minimally invasive surgical method,with accurate positioning,short operation time,less intraoperative bleeding and low complications.