微创医学

目的探讨单纯内镜黏膜下剥离术与综合微创手术治疗胃肠道间质瘤的临床效果。方法对胃肠道间质瘤直径小于2 cm患者进行抽样，选取68例随机分成两组，对照组34例，行单纯内镜黏膜下剥离术，实验组34例，实施综合微创手术治疗，对比两组临床治疗效果。结果实验组总有效率（94.12% vs 64.70%）明显高于对照组，且肿瘤切除率（100.00% vs 76.47%）显著大于对照组，术中出血率（35.29% vs 100.00%）、术中穿孔率（2.94% vs 23.52%）、住院时间（d：3.32±1.00 vs 4.52±1.01）及手术费用（元：3 333.43±233.65 vs 3973.43±378.54）均低于对照组，并发症发生率（0 vs 20.59%）较对照组低，差异有统计学意义（P＜0.05）。结论综合微创手术治疗胃肠道间质瘤的临床疗效优于单纯内镜黏膜下剥离术，安全指数更高。

Objective To explore the clinical efficacy of simple endoscopic submucosal dissection and comprehensive minimally invasive surgery in gastrointestinal stromal tumor(GIST). Methods 68 cases were selected from patients with GIST (the diameter of tumor is less than 2cm) .All cases were randomly divided into control group (n=24) and experimental group (n=24). Simple endoscopic submucosal dissection was performed in the control group, and comprehensive minimally invasive surgery was performed in the experimental group. The clinical efficacy was compared between two groups. Results The total effective rate and tumor resection rate in the experimental group (94.12% and 100.00%, respectively) were significantly higher than those in the control group (64.70% and 76.47%, respectively) (P＜0.05). The intraoperative hemorrhage rate, intraoperative perforation rate and incidence of complication were lower in the experimental group (35.29%, 2.94% and 0 %, respectively) compared with the control group (100.00%, 23.52% and 20.59%, respectively) (P＜0.05). The hospital stay in the experimental group was shorter than that in the control group ［(3.32±1.00) d vs (4.52±1.01) d, P＜0.05］. And the surgical cost in the experimental group was less than that in the control group ［(333.43±233.65) yuan vs (3973.43±378.54) yuan, P＜0.05］. Conclusions The comprehensive minimally invasive surgery is more effective and safe than the simple endoscopic submucosal dissection.