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[腹腔镜手术治疗原发性局部胃肠间质瘤的疗效分析]

[Efficacy analysis of laparoscopic surgery for primary local gastric and intestinal gastrointestinal stromal tumors].

作者信息

Zhang Xinhua, Song Wu, Han Fanghai, Chen Chuangqi, Song Xinming, Chen Jianhui, Cai Shirong, He Yulong, Zhan Wenhua

机构信息

Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Apr;17(4):340-3.

Abstract

OBJECTIVE

To investigate the feasibility and short-term efficacy of laparoscopic resection of primary local gastric and intestinal gastrointestinal stromal tumors(GIST).

METHODS

Clinicopathological data of 26 patients with GIST, 20 located at the stomach and 6 at the intestine, undergoing laparoscopic complete resection from October 2010 to April 2013 were retrospectively analyzed.

RESULTS

Hand-assisted laparoscopic surgery was performed in 3 patients with gastric GIST, while the other 23 underwent regular laparoscopic surgery. All the procedures were performed successfully without conversion to open operation. According to tumor location and growth types, gastric local resection was performed in 18 cases, distal gastrectomy in 2 cases and intestinal segmental resection in all 6 cases of intestinal GIST. The mean diameter of tumor was (4.5±1.6) cm. The mean operational time was(96.2±28.2) min, with a mean blood loss of (49.6±38.6) ml. Postoperative bowel function recovery time was (2.3±0.7) d and the length of postoperative hospital stay was (6.8±1.9) d. Bleeding from gastrointestinal tract developed in 1 patient after resection of intestinal GIST. Postoperative pathology indicated very low risk of GIST in 1(3.8%), low risk in 13(50.0%), intermediate in 9(34.6%) and high risk in 3(11.5%) patients, respectively. After a follow-up ranging form 3 to 32 months, no recurrence or death was found.

CONCLUSION

Laparoscopic surgery of primary local GISTs from stomach or intestine is safe and feasible in selected patients, with less invasiveness, rapid recovery, and favorable short-term outcomes.

摘要

目的

探讨腹腔镜切除原发性局部胃及肠道胃肠道间质瘤(GIST)的可行性及短期疗效。

方法

回顾性分析2010年10月至2013年4月期间26例行腹腔镜完整切除的GIST患者的临床病理资料,其中20例位于胃,6例位于肠道。

结果

3例胃GIST患者行手辅助腹腔镜手术,其余23例行常规腹腔镜手术。所有手术均成功完成,无一例中转开腹。根据肿瘤位置及生长类型,18例行胃局部切除,2例行远端胃切除,6例肠道GIST均行肠段切除。肿瘤平均直径为(4.5±1.6)cm。平均手术时间为(96.2±28.2)分钟,平均出血量为(49.6±38.6)ml。术后肠功能恢复时间为(2.3±0.7)天,术后住院时间为(6.8±1.9)天。1例肠道GIST切除术后出现消化道出血。术后病理显示,GIST极低危1例(3.8%),低危13例(50.0%),中危9例(34.6%),高危3例(11.5%)。随访3至32个月,无复发及死亡病例。

结论

对于经选择的患者,腹腔镜手术切除原发性局部胃或肠道GIST安全可行,具有创伤小、恢复快及短期疗效良好的特点。

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