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腹腔镜下胃黏膜下肿瘤楔形切除术

Laparoscopic wedge resection of gastric submucosal tumors.

作者信息

Otani Y, Ohgami M, Igarashi N, Kimata M, Kubota T, Kumai K, Kitajima M, Mukai M

机构信息

Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Surg Laparosc Endosc Percutan Tech. 2000 Feb;10(1):19-23.

Abstract

Minimally invasive surgery has revolutionized the treatment of gastrointestinal tumors. Submucosal tumors (SMTs) of the stomach can be resected using laparoscopic techniques. Between 1993 and 1997, laparoscopic wedge resection was performed in 34 patients with an SMT of the stomach. The tumors ranged from 8 to 60 mm in diameter. All surgical margins were clear. The average operative time was 131 minutes. Most of the patients began eating on the first postoperative day and were discharged within 5 to 7 days. Histopathologic examination of the tumors showed gastrointestinal stromal tumor (n = 14), ectopic pancreas (n = 7), leiomyosarcoma (n = 4), schwannoma (n = 3), carcinoid (n = 2), leiomyoma (n = 2), an inflammatory lesion caused by parasites (n = 1), and cyst (n = 1). No recurrences were observed over the 5-year follow-up period. A solid SMT of the stomach larger than 20 mm in diameter can be treated using laparoscopic wedge resection.

摘要

微创手术彻底改变了胃肠道肿瘤的治疗方式。胃黏膜下肿瘤(SMT)可采用腹腔镜技术进行切除。1993年至1997年间,对34例胃SMT患者进行了腹腔镜楔形切除术。肿瘤直径为8至60毫米。所有手术切缘均清晰。平均手术时间为131分钟。大多数患者术后第一天开始进食,并在5至7天内出院。肿瘤的组织病理学检查显示为胃肠道间质瘤(n = 14)、异位胰腺(n = 7)、平滑肌肉瘤(n = 4)、神经鞘瘤(n = 3)、类癌(n = 2)、平滑肌瘤(n = 2)、寄生虫引起的炎性病变(n = 1)和囊肿(n = 1)。在5年的随访期内未观察到复发。直径大于20毫米的胃实性SMT可采用腹腔镜楔形切除术治疗。

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