胃镜联合腹腔镜对胃间质瘤切除的临床疗效及预后并发症的影响

Effect of Gastroscopy Combined with Laparoscopy on the Clinical Efficacy and Prognostic Complications of Gastric Stromal Tumor Resection

目的探究胃间质瘤患者应用胃镜联合腹腔镜治疗的临床效果及对预后并发症的影响。方法于2021年7月至2023年9月选取启东市人民医院接收的80例胃间质瘤患者,按照随机数字表形式将其分为研究组(40例)与对照组(40例)。研究组采用胃镜联合腹腔镜胃间质瘤切除术,对照组采用开腹胃间质瘤切除术。对比两组的围手术期指标[术中出血量、时间指标(手术、肛门首次排气、引流管拔除、住院方面)以及住院费用];统计分析两组胃出血、切口感染、腹腔感染、肺部感染、肠管损伤等并发症情况的发生率及随访结果(中位随访时间及复发率)。结果相比于对照组,研究组的术中出血量更少,肛门首次排气时间、引流管拔除时间和住院时间更短,但手术时间更长,住院费用更高(均P<0.05)。研究组的并发症总发生率为2.50%,低于对照组的20.00%(P<0.05)。两组中位随访时间及复发率比较,差异无统计学意义(P>0.05)。结论与开腹胃间质瘤切除术比较,胃间质瘤患者应用胃镜联合腹腔镜背景下的胃间质瘤切除术对患者的损伤更小,并发症也更少,安全性高,具有更好的疗效。

Objective To investigate the clinical efficacy and impact on postoperative complications of endoscopic and laparoscopic surgery for patients with gastric gastrointestinal stromal tumors(GIST).Methods From July 2021 to September 2023,80 patients with gastric GIST admitted to Qidong People’s Hospital were selected and divided into a study group(40 cases)and a control group(40 cases)using a random number table.The study group underwent endoscopic and laparoscopic resection of GIST,while the control group underwent open resection of GIST.The perioperative indicators of the two groups were compared,including intraoperative blood loss,time indicators(surgery,first anal flatus,drainage tube removal,hospital stay),and hospitalization costs.The incidence of complications such as gastric bleeding,incision infection,abdominal infection,pulmonary infection,and intestinal injury was statistically analyzed,as well as follow-up results(median follow-up time and recurrence rate).Results Compared with the control group,the study group had less intraoperative blood loss,shorter times for first anal flatus,drainage tube removal,and hospital stay,but longer surgery time and higher hospitalization costs(all P<0.05).The total incidence of complications in the study group was 2.50%,which was lower than the control group’s 20.00%(P<0.05).There was no significant difference in median follow-up time and recurrence rate between the two groups(P>0.05).Conclusions Compared with open GIST resection,patients with gastric GIST who underwent endoscopic and laparoscopic GIST resection experienced less tissue damage,fewer complications,higher safety,and better therapeutic outcomes.