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基于生长模式的胃胃肠道间质瘤腹腔镜部分切除术策略

Strategy of Laparoscopic Partial Resection for Gastric Gastrointestinal Stromal Tumors According to the Growth Pattern.

作者信息

Kawamura Hideki, Shibasaki Susumu, Yoshida Tadashi, Homma Shigenori, Takahashi Masahiro, Taketomi Akinobu

机构信息

*Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine †Department of Surgery, JA Sapporo Kosei Hospital, Sapporo, Japan.

出版信息

Surg Laparosc Endosc Percutan Tech. 2015 Dec;25(6):e175-9. doi: 10.1097/SLE.0000000000000212.

Abstract

Laparoscopic partial gastrectomy is the standard surgical treatment for gastric gastrointestinal stromal tumor (GIST). However, to reduce gastric deformation, the tumor margins should be secured so as to minimize the size of the resection as much as possible. This is the report on the 3 laparoscopic resection techniques for gastric GIST depending upon the growth pattern and location of the tumor, and their results. We performed laparoscopic partial gastrectomy for 41 gastric GISTs between 2004 and 2012. Simple resection was used on exophytic or small GISTs. Seromuscular resection was used on exoendophytic (intramural) and relatively small endophytic tumors. Transgastric resection was used in cases of large endophytic tumors. We performed simple resection on 24 lesions (58.5%), seromuscular resection on 14 lesions (34.1%), and transgastric resection on 3 lesions (7.3%). There were no intraoperative complications. Postoperative complications included 1 case (2.5%) of bleeding from the staple line.

摘要

腹腔镜部分胃切除术是胃胃肠道间质瘤(GIST)的标准手术治疗方法。然而,为减少胃变形,应确保肿瘤切缘,尽可能缩小切除范围。本文报告了根据肿瘤生长方式和位置的3种腹腔镜胃GIST切除技术及其结果。2004年至2012年期间,我们对41例胃GIST进行了腹腔镜部分胃切除术。对向腔内生长或较小的GIST采用单纯切除术。对向腔内外生长(壁内)和相对较小的向腔内生长肿瘤采用浆肌层切除术。对较大的向腔内生长肿瘤采用经胃切除术。我们对24个病灶(58.5%)进行了单纯切除术,对14个病灶(34.1%)进行了浆肌层切除术,对3个病灶(7.3%)进行了经胃切除术。术中无并发症。术后并发症包括1例(2.5%)吻合口出血。

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