微创医学

目的探讨内镜和腹腔镜辅助下胃间质瘤切除的临床效果。方法将84例直径<3.0 cm且边界清晰的胃间质瘤患者随机分为2组,每组42例。观察组行内镜辅助切除术,对照组行腹腔镜辅助切除。对两组围手术期情况、并发症、复发、转移情况进行观察。结果观察组手术用时、术中出血量和术后通便时间分别为(50.6±4.9)min、(10.9±2.7)m L、(18.4±4.7)h,均显著性低于对照组的(70.4±12.4)min、(20.7±5.4)m L、(24.5±4.8)h,两组比较,差异有统计意义(P<0.05);但在术后胃管留置时间、禁食时间、术后住院时间,两组比较,差异无统计学意义(P>0.05)。观察组并发症率为4.8%(2/42),高于对照组的0%(0/42),但差异无统计学意义(P>0.05)。两组患者均未出现胃间质瘤的复发和转移。结论相比于腹腔镜,内镜辅助下手术可有效的对直径<3.0 cm且边界清晰的胃间质瘤进行切除,具有创伤小、恢复快的优点。

Objective To investigate the efficacy of endoscopy and laparoscopy on removal of gastric stromal tumors. Methods 84 cases of gastric stromal tumors with diameter less than 3. 0 cm and a clear boundary were randomly divided into two groups,42 cases in each group. Patients in observation group were given endoscopic resection and patients in control group were given laparoscopic resection. The perioperative situation,complications,recurrence,and metastasis of two groups were observed. Results The surgical time,blood loss and postoperative laxative time in the observation group were (50. 6 ± 4. 9 ) min, (10. 9 ±2. 7)mL,(18. 4 ±4. 7)h,respectively,which were significantly lower than those of control group [(70. 4 ±12. 4)min,(20. 7 ±5. 4)mL,(24. 5 ± 4. 8)h](P < 0. 05). But there were no differences in the retain time of gastric tube,fasting time,and postoperative hospital stay time (P > 0. 05 ). The complication rate of observation group was 4. 8% ,which was higher than that of the control group (0% ),but the difference was no statistically significant (P > 0. 05). There was neither recurrence nor metastasis of gastric stromal tumor in both two groups. Conclusion Compared with laparoscopy,endoscopic resection can effectively removal gastric stromal tumors with diameter less than 3. 0cm and a clear boundary,with the advantages of less trauma and faster recovery.