Ma Zhi-qiang, Yu Jian-chun, Kang Wei-ming
Department of General Surgery, PUMC Hospital, CAMS and PUMC, Beijing, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2012 Apr;34(2):159-63. doi: 10.3881/j.issn.1000-503X.2012.02.011.
To evaluate the feasibility of laparoscopic and endoscopic cooperative partial gastrectomy,a minimally invasive surgery, in treating gastric submucosa lesion.
We retrospectively analyzed 63 patients [34 women and 29 men, aged (52.8±18.1) years (range:14 to 78 years)] who had undergone laparoscopic and endoscopic cooperative partial gastrectomy with preserving cardia and pylorus for gastric submucosal tumor in the past 6 years. All of the patients were followed up for 2-69 months (average 35 months). The clinicopathological data, surgical approaches, and follow-up results were analyzed.
The surgery was successfully performed in all these 63 patients, among whom 61 were assisted by endoscopy. The most common symptom was dyspepsia. The mean distance from the lesions locating at fundus or antrum to cardia or pylorus was(2.9±1.1)cm. The minimum distance from tumor edge to cardia was 1cm. The diseases included gastrointestinal stromal tumor (n=54), carcinoid tumors (n=3), ectopic pancreas (n=2), lipoma (n=2), and leiomyoma (n=2). The tumor size ranged from 0.8 to 8.2cm, with 44 lesions (69.8%) less than 2cm. Forty-five lesions(71.4%) were located at fundus, 12 (19.0%) at body, and 6 (9.6%) at antrum. No recurrence or death was noted during follow-up.
Laparoscopic and endoscopic cooperative partial gastrectomy is feasible for treating gastric submucosal tumor. Endoscopy is useful for intraoperative localization and supporting, and therefore is especially helpful for preserving cardia and pylorus.
评估腹腔镜与内镜协作下的微创部分胃切除术治疗胃黏膜下病变的可行性。
回顾性分析过去6年中63例行腹腔镜与内镜协作下保留贲门和幽门的部分胃切除术治疗胃黏膜下肿瘤的患者[34例女性和29例男性,年龄(52.8±18.1)岁(范围:14至78岁)]。所有患者均随访2至69个月(平均35个月)。分析临床病理资料、手术方式及随访结果。
63例患者手术均成功,其中61例术中借助内镜。最常见症状为消化不良。位于胃底或胃窦的病变距贲门或幽门的平均距离为(2.9±1.1)cm。肿瘤边缘距贲门的最小距离为1cm。疾病包括胃肠道间质瘤(n = 54)、类癌(n = 3)、异位胰腺(n = 2)、脂肪瘤(n = 2)和平滑肌瘤(n = 2)。肿瘤大小为0.8至8.2cm,44个病变(69.8%)小于2cm。45个病变(71.4%)位于胃底,12个(19.0%)位于胃体,6个(9.6%)位于胃窦。随访期间未发现复发或死亡病例。
腹腔镜与内镜协作下部分胃切除术治疗胃黏膜下肿瘤可行。内镜有助于术中定位与支持,对保留贲门和幽门尤其有帮助。