胃造口法腹腔镜胃后壁黏膜下肿瘤切除术的临床应用

A new laparoscopic resection of posterior gastric submucosal tumor via gastrostomy

目的探讨胃造口法腹腔镜胃后壁黏膜下肿瘤切除术的临床应用价值。方法回顾性总结42例胃肿瘤患者采用此法治疗的临床资料,包括病灶位于胃体后壁23例,胃底后壁19例;肿瘤直径1.5～5.2(平均2.4)cm。术式主要步骤为病灶定位、胃前壁切开、肿瘤提出胃腔、肿瘤切除、前壁缝合。结果41例手术获得成功,平均手术时间68min,平均术中出血25ml。术后疼痛轻微,术后第1天可恢复活动,第3天恢复进食,平均住院天数7.4d。有5例患者术后病理显示为低度恶性间质瘤,随访10～48个月未见复发。结论胃造口法腹腔镜胃后壁黏膜下肿瘤切除术是一种简便、安全、有效的微创手术方法,值得临床推广应用。

Objective To investigate the value of a new laparoscopic resection of posterior gastric submucosal tumor via gastrostomy. Methods The main steps of this procedure included locating lesion, incising anterior gastric wall, extracting the tumor outside the gastric lumen, resecting the tumor and suturing the anterior wall. Forty two cases received this new type of operation. The tumors ranged in size from 1.5 to 5.2 cm with a mean diameter of 2.4 cm. Results The operations were successful performed in 41 cases. The mean operative time was 68min. The mean intraoperative blood loss was 25 ml. Postoperative pain was slight. The patients could resume movement on the first day and food intake on the third day postoperatively. The mean hospital stay was 7.4 days. No recurrence occurred in 5 cases with postoperatively proven low grade malignant stromal turmor after follow up for 10 to 48 months. Conclusion This new laparoscopic resection of posterior gastric submucosal tumor via gastrostomy is a technically simple, safe and effective procedure.