Huang Jiang-Long, Zheng Zong-Heng, Wei Hong-Bo, Chen Tu-Feng, Liu Jian-Pei, Huang Yong, Wei Bo, Fang Jia-Feng
Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou, China .
J Laparoendosc Adv Surg Tech A. 2017 Feb;27(2):110-114. doi: 10.1089/lap.2016.0068. Epub 2017 Jan 11.
To explore the safety, feasibility, and clinical curative effect of endoscopy-assisted laparoscopic resections for gastric gastrointestinal stromal tumors (GISTs).
We retrospectively compared the general condition of 41 GIST patients undergoing endoscopy-assisted laparoscopic resections (n = 41, combined group) with those undergoing traditional open gastrectomy (n = 43, open surgery group).
All patients survived during the surgery. The average operation time of the combined group and the open surgery group was 90 ± 40 minutes and 120 ± 60 minutes, respectively, and no significant difference (P = .088) was observed. Bleeding volume during operation was significantly lower [(50 ± 20 versus 150 ± 40) mL, P < .001] and recovery time of the gastrointestinal function was significantly shorter in the combined group [(2.02 ± 0.99) days versus (3.02 ± 1) days, P < .001]. No statistical difference was found in the postoperative complications (5% versus 12%, P = .442) or GIST recurrence (2.44% versus 2.33%, P = 1.000) between the two groups. Follow-up visit showed no death.
For GIST patients who attempted to receive gastrectomy, endoscopy-assisted laparoscopic resections showed advantages on the operation time, bleeding volume, and recovery time and are suggested as a better alternative for GISTs.
探讨内镜辅助腹腔镜切除胃胃肠道间质瘤(GIST)的安全性、可行性及临床疗效。
我们回顾性比较了41例行内镜辅助腹腔镜切除的GIST患者(n = 41,联合组)与43例行传统开腹胃切除术患者(n = 43,开放手术组)的一般情况。
所有患者手术期间均存活。联合组和开放手术组的平均手术时间分别为90±40分钟和120±60分钟,差异无统计学意义(P = 0.088)。联合组术中出血量显著更低[(50±20)ml对(150±40)ml,P < 0.001],胃肠功能恢复时间显著更短[(2.02±0.99)天对(3.02±1)天,P < 0.001]。两组术后并发症(5%对12%,P = 0.442)或GIST复发(2.44%对2.33%,P = 1.000)差异均无统计学意义。随访无死亡病例。
对于拟行胃切除术的GIST患者,内镜辅助腹腔镜切除在手术时间、出血量及恢复时间方面具有优势,可作为GIST较好的手术方式选择。