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目的内镜、腹腔镜和开放手术都是治疗相对较小(2~4cm)胃肠道间质瘤(GISTs)的方法。但是,临床中选择哪种治疗方法仍然存在争议。本研究中应用肿瘤大小-配对研究方法,比较这些治疗方法的短期和长期预后。方法本研究收集了80例胃间质瘤患者,其间质瘤大小在2至4cm之间,对这些患者的临床资料进行回顾性分析。评价这些患者的临床数据,围手术期数据和肿瘤学数据。结果 18例患者进行内镜治疗,20例患者行腹腔镜治疗,其余42例行开放手术治疗。三组间的临床数据没有显著的差异,符合研究预期。内镜切除组手术时间最短、出血量最少、术后住院时间最短及最早开始进食流质饮食和半流质饮食。此外,腹腔镜组的短期预后明显好于开放手术组。对于治疗费用及术后严重并发症的发生,3种治疗组之间无明显差异。该研究病例在随访过程中均未出现复发。结论对于相对较小的胃间质瘤,内镜下切除是有效的,安全的,可行的微创治疗方法。
Endoscopic, laparoscopic, and open surgery are all methods of treating relatively small (2 to 4 cm) gastrointestinal stromal tumors (GISTs). However, it is still controversial to choose which treatment method in clinical practice. Tumor size-matched studies were used in this study to compare the short-term and long-term outcomes of these therapies. Methods Totally 80 patients with gastric stromal tumors were collected. The size of stromal tumors was between 2 and 4 cm. The clinical data of these patients were retrospectively analyzed. The clinical data, perioperative data and oncology data of these patients were evaluated. Results Eighteen patients underwent endoscopic treatment, 20 underwent laparoscopy and the remaining 42 underwent open surgery. There was no significant difference in the clinical data among the three groups, in line with the study’s expectation. The endoscopic resection group had the shortest operation time, the least amount of bleeding, the shortest postoperative hospital stay and the earliest start to eat liquid diet and semi-liquid diet. In addition, the short-term prognosis of the laparoscopic group was significantly better than that of the open surgery group. There was no significant difference between the three treatment groups for treatment costs and the occurrence of serious postoperative complications. The study cases did not recur during follow-up. Conclusion For relatively small gastric stromal tumors, endoscopic resection is an effective, safe and feasible minimally invasive treatment.