腹腔镜胃内手术再探讨：其在食管胃交界部附近黏膜下肿瘤治疗中的作用
Laparoscopic intragastric surgery revisited: its role for submucosal tumors adjacent to the esophagogastric junction.
作者信息
Hara Johji, Nakajima Kiyokazu, Takahashi Tsuyoshi, Yamasaki Makoto, Miyata Hiroshi, Kurokawa Yukinori, Takiguchi Shuji, Mori Masaki, Doki Yuichiro
机构信息
Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
出版信息
Surg Laparosc Endosc Percutan Tech. 2012 Jun;22(3):251-4. doi: 10.1097/SLE.0b013e3182508083.
PURPOSE
When the gastric submucosal tumor (SMT) locates adjacent to the esophagogastric junction (EGJ), it is difficult to preserve EGJ technically and oncologically. In this study, we describe our clinical experience with laparoscopic intragastric surgery (LIGS) and discuss its role for gastric SMTs adjacent to EGJ.
METHODS
A retrospective review was performed on patients who underwent surgical treatment of gastric SMTs adjacent to EGJ (April 1994 to May 2010). They were divided into 3 groups: laparoscopic partial gastrectomy (LAP, n=10), LIGS (n=10), and open laparotomy (OPEN, n=7), respectively.
RESULTS
The completion rates were 50% in LAP and 90% in LIGS. Overall preservation rate of EGJ was 80% (LAP), 100% (LIGS), and 29% (OPEN), respectively. The patients who underwent total/proximal mastectomy showed significantly higher incidence of postoperative gastrointestinal symptoms, which required long-term medication.
CONCLUSIONS
LIGS stays as a valuable alternative and would be an attractive option for gastric SMTs adjacent to EGJ.
目的
当胃黏膜下肿瘤（SMT）位于食管胃交界（EGJ）附近时，在技术和肿瘤学方面难以保留EGJ。在本研究中，我们描述了我们的腹腔镜胃内手术（LIGS）临床经验，并讨论其在EGJ附近胃SMT中的作用。
方法
对接受EGJ附近胃SMT手术治疗的患者（1994年4月至2010年5月）进行回顾性研究。他们分别分为3组：腹腔镜部分胃切除术（LAP，n = 10）、LIGS（n = 10）和开腹手术（OPEN，n = 7）。
结果
LAP的完成率为50%，LIGS为90%。EGJ的总体保留率分别为80%（LAP）、100%（LIGS）和29%（OPEN）。接受全乳/近端乳房切除术的患者术后胃肠道症状发生率显著更高，需要长期药物治疗。
结论
LIGS仍然是一种有价值的替代方法，对于EGJ附近的胃SMT将是一个有吸引力的选择。
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