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直径小于 10cm 的小肠胃肠道间质瘤的治疗结果:腹腔镜与开放手术的比较。

Treatment Results of Small Intestinal Gastrointestinal Stromal Tumors Less than 10 cm in Diameter: A Comparison between Laparoscopy and Open Surgery.

机构信息

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

出版信息

J Gastric Cancer. 2012 Dec;12(4):243-8. doi: 10.5230/jgc.2012.12.4.243. Epub 2012 Dec 31.

Abstract

PURPOSE

To evaluate the technical feasibility and oncologic safety, we assessed the short-term and long-term outcomes of laparoscopic resection of the small bowel gastrointestinal stromal tumors smaller than 5 cm by comparing those of open surgery by subgroup analysis based on tumor size.

MATERIALS AND METHODS

From November 1993 to January 2011, 41 laparoscopic resections were performed among the 95 patients who underwent resection of small intestine ≤10 cm in diameter. The clinicopathologic features, perioperative outcomes, recurrences and survival of these patients were reviewed.

RESULTS

The postoperative morbidity rates were comparable between the 2 groups. Laparoscopic surgery group showed significantly shorter operative time (P=0.004) and duration of postoperative hospital stay (P<0.001) than open surgery group and it was more apparent in the smaller tumor size group. There were no difference in 5-year survival for the laparoscopic surgery versus open surgery groups (P=0.163), and in 5-year recurrence-free survival (P=0.262). The subgroup analysis by 5 cm in tumor size also shows no remarkable differences in 5-year survival and recurrence-free survival.

CONCLUSIONS

Laparoscopic resection for small bowel gastrointestinal stromal tumors of size less than 10 cm has favorable short-term postoperative outcomes, while achieving comparable oncologic results compared with open surgery. Thus, laparoscopic approach can be recommended as a treatment modality for patients with small bowel gastrointestinal stromal tumors less than 10 cm in diameter.

摘要

目的

通过亚组分析评估基于肿瘤大小的腹腔镜与开放手术治疗小肠<5cm 胃肠道间质瘤的短期和长期结果,评估腹腔镜切除小肠<5cm 胃肠道间质瘤的技术可行性和肿瘤安全性。

材料与方法

1993 年 11 月至 2011 年 1 月,95 例直径≤10cm 的小肠切除术患者中,有 41 例行腹腔镜切除术。回顾这些患者的临床病理特征、围手术期结果、复发和生存情况。

结果

两组患者术后发病率相当。腹腔镜手术组的手术时间(P=0.004)和术后住院时间(P<0.001)明显短于开放手术组,且在肿瘤较小的组中更为明显。腹腔镜手术组与开放手术组的 5 年生存率无差异(P=0.163),无复发生存率也无差异(P=0.262)。肿瘤大小为 5cm 的亚组分析也显示,5 年生存率和无复发生存率无显著差异。

结论

腹腔镜切除<10cm 大小的小肠胃肠道间质瘤具有良好的短期术后结果,与开放手术相比,可获得相似的肿瘤学结果。因此,腹腔镜方法可以作为直径<10cm 的小肠胃肠道间质瘤患者的一种治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce26/3543975/f3e9e60b39ff/jgc-12-243-g001.jpg

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