摘要
目的探讨腹腔镜联合胃镜微创手术治疗胃间质瘤的临床应用方法及价值。方法回顾性分析我院2011年6月至2012年10月双镜联合微创外科治疗胃间质瘤48例的临床和病理资料。结果 42例胃间质瘤在胃镜辅助下行腹腔镜下胃楔形切除,手术时间(50~240)min[平均(92±45)min],术中出血量(5~80)ml[平均(30±18.6)ml],术后平均住院日4~8天,无并发症发生。其中6例肿瘤临近贲门和幽门,均成功地保留了贲门和幽门。6例在胃镜下完成胃间质瘤切除,其中4例行胃镜黏膜下切除,2例由于肿瘤位于肌层,胃镜下切除后穿孔,1例行胃镜下缝合夹夹闭,1例行腹腔镜下缝合修补。肿瘤直径(1.0~5.2)cm[平均(3.2±1.8)cm]。病理结果:极低复发危险32例,低度复发危险12例,中度复发危险3例,高度复发危险1例。随访2~18月,无复发及转移。结论腹腔镜联合胃镜应用具有手术时间短、创伤小、恢复快、美容效果好、安全有效等优点,是直径【5 cm的胃间质瘤的优选治疗方式。
Objective To explore the clinical methods and effects of laparoscopy combined with gastroscopy resection on gastric stromal tumor patients. Methods Data of 48 patients with gastrointestinal stromal tumor treated by laparoscopy combined with gastroscopy resection from June 2011 to October 2012 were analyzed retrospectively. Results Forty-two patients with gastric stromal tumor received laparoscopically extragastric wedge resection by localization of gastroscope for 50-240 min, with an average of(92±45) min. The intranperative blood loss was 5-80 ml approximately, with an average of(30±18.6) ml. The mean postoperative hospital stay was 4-8 days and no postoperative complication was occurred. Among these 42 patients, the operations on 6 patients with tumors located near to the cardia(≤5cm) or pylorus(≤5cm) were successful without rupture of the cardia or pylorus. In 6 cases performed by gastroscopy, 4 received gastroscopic submucosal dissection, 2 received gastroscopic resection fi rstly and perforation in gastric wall due to the complicated location in muscular layer, clipping the gastric perforation with gastroscopy in one case and the laparoscopic suture repair was performed in the other. The diameter of tumor ranged from 1.0cm to 5.2cm, with an average of(3.2±1.8)cm. Pathologic analysis of 48 resected specimens showed 32 cases with extremely low risk, 12 cases with low risk, 3 cases with middle risk and 1 case with high risk. No case of recurrence or metastasis was found during a follow-up period for 2-18 months. Conclusion Laparoscopic combined with gastroscopic resection for gastric stromal tumor is a safe and effective therapy with many advantages, such as, short operation time, minimal invasive, fast recovery, good cosmetic results, and can be considered as the preferred option for treatment on patients with gastric stromal tumor with diameter < 5cm.
出处
《肿瘤防治研究》
CAS
CSCD
北大核心
2014年第2期157-159,共3页
Cancer Research on Prevention and Treatment
关键词
腹腔镜
胃镜
胃肠道间质瘤
胃切除术
Laparoscopy
Gastroscopy
Gastric stromal tumor
Gastrectomy
