Sista Federico, Pessia Beatrice, Abruzzese Valentina, Cecilia Emanuela Marina, Schietroma Mario, Carlei Francesco, Amicucci Gianfranco
Ann Ital Chir. 2015 Jul-Aug;86(4):349-56.
The authors wanted to evaluate the outcome of laparoscopic and open resection for gastric GISTs, in the long and short run with a retrospective study based on 63 consecutive patients.
Two surgical groups were compared according to age, sex, ASA group and Surgical procedure: a laparoscopic resection was performed on 30 patients (47,7%) while the open approach was preferred for 33 patients (52,3%). Duration of surgery, blood loss, positive resection margins, postoperative morbidity, postoperative ileus, hospital stay, tumor's mean dimensions, degree of malignancy and recurrences rate and 5-years mortality were compared in subgroups.
Significant differences between Open Gastrectomy group and Laparoscopic Gastrectomy group were found in blood loss 425 ml (180-610) vs 137 ml (110-320), postoperative ileus 4,1D (3-6) vs 2,3D (1-7), hospital stay 15D (8-25) vs 10D (8-17), neoplasia mean dimensions in patients who underwent total gastrectomy ( 7,1±0,9 cm vs 5,3±0,5 cm) and atypical gastrectomy (4,3±0,8 cm vs 2,2±0,3 cm), high degree of malignancy in patients who underwent subtotal gastrectomy (4 vs 0 pz) and 5-years mortality in patients who underwent total gastrectomy (36.6% vs 12.5%).
Poor blood loss, shorter postoperative ileus and shorter hospital stay in the LG group show that laparoscopy can be performed safely and efficiently in gastric GISTs.
作者希望通过一项基于63例连续患者的回顾性研究,评估腹腔镜手术和开放手术切除胃间质瘤的短期和长期结果。
根据年龄、性别、美国麻醉医师协会(ASA)分级和手术方式对两个手术组进行比较:30例患者(47.7%)接受了腹腔镜切除术,而33例患者(52.3%)更倾向于开放手术。对亚组中的手术时间、失血量、切缘阳性情况、术后发病率、术后肠梗阻、住院时间、肿瘤平均大小、恶性程度、复发率和5年死亡率进行了比较。
开放胃切除术组和腹腔镜胃切除术组之间在以下方面存在显著差异:失血量425毫升(180 - 610)对比137毫升(110 - 320);术后肠梗阻4.1天(3 - 6)对比2.3天(1 - 7);住院时间15天(8 - 25)对比10天(8 - 17);接受全胃切除术患者的肿瘤平均大小(7.1±0.9厘米对比5.3±0.5厘米)和接受非典型胃切除术患者的肿瘤平均大小(4.3±0.8厘米对比2.2±0.3厘米);接受胃次全切除术患者的高度恶性情况(4对比0,pz)以及接受全胃切除术患者的5年死亡率(36.6%对比12.5%)。
腹腔镜胃切除术组失血量少、术后肠梗阻时间短和住院时间短,表明腹腔镜手术可安全有效地用于胃间质瘤手术。