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腹腔镜超声引导下胃黏膜下肿瘤切除术。

Laparoscopic ultrasound-guided resection of gastric submucosal tumors.

作者信息

Santambrogio R, Montorsi M, Schubert L, Pisani Ceretti A, Costa M, Moroni E, Opocher E

机构信息

Department of Surgery, Unità di Chirurgia Bilio-pancreatica, University of Milano School of Medicine, Azienda Ospedaliera San Paolo, via A. di Rudinì 8, 20142, Milano, Italy.

出版信息

Surg Endosc. 2006 Aug;20(8):1305-7. doi: 10.1007/s00464-005-0600-0. Epub 2006 Jul 24.

Abstract

BACKGROUND

The laparoscopic resection of gastric stromal tumors is being performed with increased frequency. Wedge resection of anterior wall lesions is generally performed. The treatment of posterior wall lesions is still controversial.

METHODS

We report three cases of gastric submucosal tumors treated by a laparoscopic wedge resection of the stomach. All lesions were localized anterior gastric wall by intraoperative ultrasound on the. In the first patient the resection was performed with an endoscopic stapler; in the other patients, ultrasonic coagulation in association with an intracorporeal suture has been used.

RESULTS

All patients were successfully treated laparoscopically; there were no conversions to open surgery. In all cases the operative course was uneventful. The postoperative hospital stay ranged from 6 to 8 days.

CONCLUSIONS

The results suggest that laparoscopic surgery is an adequate strategy for gastric submucosal neoplasms including gastrointestinal stromal tumors (GIST). Intraoperative ultrasound is very useful in the selection of the technical approach with or without the endoscopic stapler.

摘要

背景

腹腔镜下胃间质瘤切除术的开展频率日益增加。通常对前壁病变进行楔形切除术。而后壁病变的治疗仍存在争议。

方法

我们报告了3例通过腹腔镜胃楔形切除术治疗的胃黏膜下肿瘤病例。所有病变经术中超声定位均位于胃前壁。第1例患者使用内镜吻合器进行切除;其他患者则采用超声凝固联合体内缝合的方法。

结果

所有患者均成功接受了腹腔镜手术,无一例转为开腹手术。所有病例手术过程均顺利。术后住院时间为6至8天。

结论

结果表明,腹腔镜手术是治疗包括胃肠道间质瘤(GIST)在内的胃黏膜下肿瘤的一种合适策略。术中超声对于选择是否使用内镜吻合器的技术方法非常有用。

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