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腹腔镜与开放手术切除胃胃肠道间质瘤的单中心经验

Single center experience of laparoscopic vs. open resection for gastrointestinal stromal tumors of the stomach.

作者信息

Pitsinis V, Khan A Z, Cranshaw I, Allum W H

机构信息

Gastrointestinal Surgical Unit, The Royal Marsden Hospital, Chelsea London, UK.

出版信息

Hepatogastroenterology. 2007 Mar;54(74):606-8.

Abstract

BACKGROUND/AIMS: With better understanding of disease biology and technological advances, an increasing number of gastric gastrointestinal stromal tumors (GISTs) are being resected laparoscopically. We assessed our management of gastric GISTs in our institution.

METHODOLOGY

Prospectively collected data from 13 patients who underwent surgery for gastric gastrointestinal stromal tumors over an 18-month period were analyzed with respect to operative and oncological outcomes. Seven patients underwent open resection and 6 patients had laparoscopic resection.

RESULTS

The tumors were evenly distributed in both groups in whom the median age was 68 years in the open group vs. 70 years in the laparoscopic group. The median operating time was 132 min in the open group and 110 min in the laparoscopic group and patients who had a laparoscopic resection had a shorter hospital stay (4 days versus 11 days). Patients in the open group had a larger tumor the patients in the laparoscopic group (11.5 x 6 x 4 cm vs. 5 x 4 x 3 cm). No patient had evidence of recurrence at median follow-up of 9 months.

CONCLUSIONS

Patients with small gastric GISTs can be safely resected with a laparoscopic approach, offering a quicker operation and shorter hospital stay. A laparoscopic approach does not alter risk of early local or distant recurrence.

摘要

背景/目的:随着对疾病生物学的深入理解和技术进步,越来越多的胃胃肠道间质瘤(GIST)通过腹腔镜进行切除。我们评估了我院胃GIST的治疗情况。

方法

对18个月期间接受胃胃肠道间质瘤手术的13例患者的前瞻性收集数据进行分析,比较手术和肿瘤学结果。7例患者接受开放切除,6例患者接受腹腔镜切除。

结果

两组肿瘤分布均匀,开放组中位年龄为68岁,腹腔镜组为70岁。开放组中位手术时间为132分钟,腹腔镜组为110分钟,接受腹腔镜切除的患者住院时间较短(4天对11天)。开放组患者的肿瘤比腹腔镜组患者的肿瘤大(11.5×6×4 cm对5×4×3 cm)。在中位随访9个月时,无患者有复发迹象。

结论

小胃GIST患者可通过腹腔镜方法安全切除,手术更快,住院时间更短。腹腔镜方法不会改变早期局部或远处复发风险。

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