Ji Zhen-Ling, Li Jun-Sheng, Zhang Wei
Department of General Surgery, Institute for Minimally Invasive Surgery, Zhong da Hospital and College of Clinical Medicine, Southeast University, PR China.
Am Surg. 2010 Jan;76(1):25-7.
Laparoscopic surgical techniques are beneficial for the wedge resection of gastrointestinal stromal tumors (GISTs). We have developed a new technique of laparoscopic transgastric resection for GISTs of the posterior wall of the stomach, a band lifting wedge resection method that has been confirmed to ensure sufficient surgical margins around the resected specimen in 21 cases. GISTs located at the posterior wall of the stomach were collected for this study. Laparoscopic anterior gastrotomy was performed and a 9-Fr rubber band was looped around the base of the tumor, allowing it to be lifted up through the anterior gastrotomy. The lesion was transected using a laparoscopic linear cutter and the gastrotomy was then closed by sequential application of the linear cutter. Surgical specimens were examined immunohistochemically. All GISTs were successfully and completely resected using the laparoscopic technique. The resected tumors were ellipse-shaped or round. Macroscopic examination of the resected specimens showed complete tumor excision with negative surgical margins in all patients. A band lifting method for transection of GISTs on the posterior wall of the stomach easily allows for sufficient surgical margins of GISTs. The technique is reliable and feasible for laparoscopic treatment of GISTs in the stomach.
腹腔镜手术技术对胃肠道间质瘤（GIST）的楔形切除有益。我们开发了一种用于胃后壁GIST的腹腔镜经胃切除术新技术，即带提吊楔形切除术，该方法已在21例病例中得到证实，可确保切除标本周围有足够的手术切缘。本研究收集了位于胃后壁的GIST。进行腹腔镜前胃切开术，用一根9F橡皮筋环绕肿瘤基部，使其通过前胃切开术被提起。使用腹腔镜直线切割器横断病变，然后通过连续应用直线切割器关闭胃切开术。对手术标本进行免疫组织化学检查。所有GIST均成功地通过腹腔镜技术完全切除。切除的肿瘤呈椭圆形或圆形。对切除标本的宏观检查显示，所有患者的肿瘤均被完全切除，手术切缘阴性。用于横断胃后壁GIST的带提吊方法能够轻松实现GIST足够的手术切缘。该技术对于腹腔镜治疗胃GIST是可靠且可行的。
