Bouillot Jean-Luc, Bresler Laurent, Fagniez Pierre Louis, Samama Guy, Champault Gérard, Parent Yves
Hôtel Dieu, Paris.
Gastroenterol Clin Biol. 2003 Mar;27(3 Pt 1):272-6.
The aim of this retrospective multicenter study was to evaluate the feasibility and the results of laparoscopic resection of benign submucosal gastric tumors.
We reviewed the cases of 65 patients (20 centers) who have been operated on laparoscopically for benign submucosal gastric tumors. The tumor was symptomatic in 56 cases, located on the posterior wall in 23 cases. The mean size of the tumor was 3.8 cm (1.5-10).
A laparoscopic wedge resection was performed in 53 cases. In 1 case a laparoscopic-assisted gastrectomy was done. A conversion to laparotomy was mandatory in 11 cases because of difficulties in localization of the tumor (n=5), in excision (n=5) or for safety reasons (n=1). There was no mortality. Two patients required reoperation because of bleeding. During follow-up, one patient developed recurrence requiring a second laparoscopic excision.
Most submucosal benign gastric tumors can be removed by laparoscopy. The location of the tumor (posterior wall or closed to the lesser curvature) or the size of the tumor (large or very small) can make the laparoscopic approach difficult.
本回顾性多中心研究旨在评估腹腔镜切除胃良性黏膜下肿瘤的可行性及结果。
我们回顾了65例(20个中心)接受腹腔镜手术治疗胃良性黏膜下肿瘤的病例。56例患者的肿瘤有症状,23例肿瘤位于后壁。肿瘤平均大小为3.8厘米(1.5 - 10厘米)。
53例行腹腔镜楔形切除术。1例行腹腔镜辅助胃切除术。11例因肿瘤定位困难(5例)、切除困难(5例)或出于安全原因(1例)而中转开腹。无死亡病例。2例患者因出血需再次手术。随访期间,1例患者复发,需再次行腹腔镜切除。
大多数胃黏膜下良性肿瘤可通过腹腔镜切除。肿瘤位置(后壁或靠近小弯侧)或肿瘤大小(大或非常小)可能使腹腔镜手术操作困难。