Aogi K, Hirai T, Mukaida H, Toge T, Haruma K, Kajiyama G
Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan.
Surg Today. 1999;29(2):102-6. doi: 10.1007/BF02482232.
In order to elucidate the efficacy in gastric surgery, we evaluated seven resected cases of a submucosal gastric tumor in which laparoscopic techniques were used. The patients consisted of 1 man and 6 women. The tumors were located in the upper, middle, and lower third of the stomach in 4, 1, and 2 cases, respectively. Three tumors were located mainly on the anterior gastric wall, 2 were on the posterior wall, and 2 were on the lesser curvature. The resected tumor size averaged 3.2 x 2.6 cm. The tumors were classified as intraluminal type (4 cases) and the extraluminal type (3 cases) according to the classification of growth type. A histopathological examination identified 4 leiomyomas, 1 leiomyosarcoma, and 4 smooth muscle tumors of indeterminate malignant potential. After a tumor resection, no recurrence of the lesions occurred during the postoperative follow-up. An extraluminal growing tumor was easily resected by the laparoscopic method without any additional procedures, and this therefore seemed to be a good indication for the laparoscopic method. In contrast, an intraluminal tumor was found to be more difficult to resect using the laparoscopic method without a companion method, e.g., intraoperative endoscopy, because of the difficulties in the detection and resection of the tumor from the serosal side. A more efficient technique must therefore be developed for this type of tumor.
为了阐明腹腔镜技术在胃部手术中的疗效，我们评估了7例采用腹腔镜技术切除的胃黏膜下肿瘤病例。患者包括1名男性和6名女性。肿瘤位于胃上、中、下三分之一处的分别有4例、1例和2例。3例肿瘤主要位于胃前壁，2例位于后壁，2例位于小弯侧。切除的肿瘤平均大小为3.2×2.6厘米。根据生长类型分类，肿瘤分为腔内型（4例）和腔外型（3例）。组织病理学检查发现4例平滑肌瘤、1例平滑肌肉瘤和4例恶性潜能不确定的平滑肌肿瘤。肿瘤切除后，术后随访期间未出现病变复发。腔外型生长的肿瘤通过腹腔镜方法很容易切除，无需任何额外操作，因此这似乎是腹腔镜方法的一个良好适应证。相比之下，腔内肿瘤若不采用辅助方法，如术中内镜检查，仅通过腹腔镜方法切除会更加困难，因为从浆膜侧检测和切除肿瘤存在困难。因此，必须为这类肿瘤开发更有效的技术。
