论文部分内容阅读
目的:探讨腹腔镜手术治疗胃间质瘤(gastric stromal tumors,GST)的临床应用价值。方法:回顾分析2003年6月至2009年2月间接受腹腔镜手术的36例GST病人的临床资料,包括手术方式、手术时间、术中失血、术后排气时间、术后住院天数、并发症、术后病理及随访资料等。结果:所有GST切除手术均在腹腔镜下完成,其中行腹腔镜胃楔形切除者21例,腹腔镜经胃肿瘤外翻切除术者12例,腹腔镜辅助远端胃切除术者2例,腹腔镜辅助下内镜胃间质瘤圈套套扎术者1例。无一例病人中转开腹手术,手术平均时间为75(30～210)min,术中平均失血60(5～150)mL,肿瘤平均大小3.0(0.5～11.5)cm,肿瘤切缘镜下均为阴性;术后平均排气时间2(1～11)d,手术后平均住院天数8(3～13)d。1例病人出现术后胃腔内出血,经保守治疗后1d出血即停止,其余病例无重大术后并发症。术后平均随访25(4～67)个月,所有病人均无肿瘤复发和远处转移。结论:腹腔镜辅助胃切除是治疗GST之安全、可行、微创、有效的手术方法。
Objective: To investigate the clinical value of laparoscopic surgery for gastric stromal tumors (GST). Methods: The clinical data of 36 GST patients undergoing laparoscopic surgery from June 2003 to February 2009 were retrospectively analyzed. The clinical data including operation mode, operation time, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay, complications Disease, postoperative pathology and follow-up information. Results: All the GST resections were performed under laparoscopy. Among them, 21 were undergone laparoscopic gastrectomy, 12 underwent laparoscopic gastrectomy, 2 were laparoscopic-assisted distal gastrectomy, Mirror - assisted endoscopic gastric stromal tumor ligation ligation in 1 case. None of the patients underwent laparotomy. The mean operation time was 75 (30-210) min. The mean intraoperative blood loss was 60 (5-150) mL. The mean tumor size was 3.0 (0.5-1.5) cm. The tumor margins were The average postoperative exhaust time was 2 (1 ~ 11) d, the average postoperative hospital stay was 8 (3 ~ 13) d. One patient showed postoperative intragastric hemorrhage, which was stopped after 1 day of conservative treatment. The remaining cases had no major postoperative complications. After an average follow-up of 25 (4 ~ 67) months, all patients had no tumor recurrence and distant metastasis. Conclusion: Laparoscopic assisted gastrectomy is a safe, feasible, minimally invasive and effective surgical method for the treatment of GST.