胃间质瘤腹腔镜手术方式的选择

Selection of Laparoscopic Surgical Approach for Gastric Mesenchymal Tumor

目的 探讨原发于胃间质瘤的腹腔镜手术方式的选择及安全性。方法 回顾性分析2019年1月—2021年2月福建省漳州市医院行手术胃间质瘤的155例患者临床资料,根据手术方式分为开腹组63例,腹腔镜手术组92例。比较两组手术相关临床资料。结果 腹腔镜组手术时间与开腹组比较,差异无统计学意义(P>0.05);腹腔镜组楔形、近端切除的切口长度、术中出血量及术后住院时间优于开腹组,差异有统计学意义(P<0.05)。腹腔镜组随访时间为(33.25±5.24)个月,开腹组随访时间(38.23±4.46)个月;腹腔镜组未出现复发转移者,开腹组中有7例患者出现破裂、复发及转移。结论 腹腔镜手术治疗胃间质瘤总体是安全、可行的,可根据肿瘤位置、大小情况可以选择不同腹腔镜手术方式,联合术中胃镜有可能减少术后并发症。

Objective To investigate the selection and safety of laparoscopic surgery for primary gastric mesenchymal tumor.Methods A retrospective analysis was conducted on the clinical data of 155 patients with gastric stromal tumors who underwent surgery at Zhangzhou City Hospital,Fujian Province from January 2019 to February 2021.They were divided into an open surgery group of 63 patients and a laparoscopic surgery group of 92 patients based on the surgical method.Compared surgical related clinical data.Results There was no statistically significant difference in surgical time between the laparoscopic group and the open group(P>0.05).The laparoscopic group had better incision length,intraoperative bleeding,and postoperative hospital stay for wedge-shaped and proximal resection compared to the open group,the difference was statistically significant(P<0.05).The follow-up time for the laparoscopic group was(33.25±5.24)months,while the follow-up time for the open group was(38.23±4.46)months.There were no recurrence or metastasis in the laparoscopic group,while 7 patients in the open group experienced rupture,recurrence,and metastasis.Conclusion Laparoscopic surgery for gastric mesenchymal stromal tumors is generally safe and feasible,and different laparoscopic surgical methods can be selected according to the location and size of the tumor,and combined with intraoperative gastroscopy has the potential to reduce postoperative complications.