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目的探讨腹腔镜与胃镜联合在切除胃间质瘤中的应用价值。方法回顾性分析我院2008年6月至2012年6月期间行腹腔镜联合胃镜治疗的45例胃间质瘤患者的临床资料。结果 45例患者均在腹腔镜与胃镜结合下成功切除胃间质瘤,肿瘤切除完整,边缘无残留。手术切口长约4～6cm(平均5.1cm),手术时间40～90min(平均75min),术后恢复顺利,未发生手术相关并发症,住院时间5～9d(平均6.8d)。随访3～24个月(平均16.5个月),未发生复发或转移。免疫组织化学检测结果:CD117阳性43例,CD34阳性32例,SMA阳性28例,Desmin阳性2例,S-100阳性22例。结论腹腔镜与胃镜结合治疗胃间质瘤,具有创伤小、手术时间短、术后恢复快等优点,同时由于有胃镜配合可以使切除范围更加精确,避免肿瘤残留及切除过多正常胃组织。
Objective To investigate the value of laparoscopy combined with endoscopy in the resection of gastric stromal tumors. Methods The clinical data of 45 patients with gastric stromal tumors treated by laparoscopy combined with endoscopy in our hospital from June 2008 to June 2012 were retrospectively analyzed. Results All 45 patients underwent resection of gastric stromal tumor with laparoscopy and gastroscope. The tumors were completely resected without residual edge. Surgical incision length was about 4 ~ 6cm (mean 5.1cm), operation time was 40 ~ 90min (average 75min), and postoperative recovery was successful. There was no operation-related complications. The hospitalization time was 5 ~ 9d (mean 6.8d). All cases were followed up for 3 to 24 months (mean 16.5 months). No recurrence or metastasis occurred. Immunohistochemical results showed that there were 43 cases of CD117 positive, 32 cases of CD34 positive, 28 cases positive SMA, 2 cases Desmin positive and 22 cases S-100 positive. Conclusions The combination of laparoscopy and gastroscopy in the treatment of gastric stromal tumors has the advantages of small trauma, short operative time and quick recovery after operation. At the same time, the scope of resection can be more accurate and the residual tumor can be removed and too much normal gastric tissue can be removed.