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[腹腔镜非典型胃切除术治疗胃间质瘤。短期和中期结果]

[Laparoscopic atypical gastrectomy in the treatment of gastric GIST. Short-term and medium-term outcomes].

作者信息

Reimondez Santiago, Moser Federico, Maldonado Pablo S, Alcaraz Álvaro, Rossini Alejandro M, Obeide Lucio R

机构信息

Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Argentina. E-mail:

Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Argentina.

出版信息

Medicina (B Aires). 2017;77(4):274-278.

Abstract

Gastrointestinal stromal tumors are the most common mesenchymal neoplasms of the gastrointestinal tract. Recently, many studies have addressed the laparoscopic management of these tumors. The aim of this study was to evaluate the safety and efficacy of laparoscopic atypical gastrectomy in the resolution of these neoplasms. In the period between January 2009 and December 2015, 24 patients with suspected gastric GIST less than 5 cm in size underwent surgery under this approach. Abscense of peritoneal and liver metastases and immunohistochemistry expression of CD117 antigen were considered as inclusion criteria. We retrospectively analyzed clinical and histopathological characteristics, surgical outcomes, postoperative complications and oncological results. Statistical analysis included 14 patients. The mean age was 60 years (10 women and 4 men) and upper gastrointestinal bleeding was the chief complaint for consultation. Conversion to open surgery was necessary in one case and no major complications, readmissions or reoperations were recorded. The mean tumor size was 41 mm with negative resection margin in all samples. The mean hospital stay was 3 days and no tumor recurrences were recorded in 44 months of follow-up. Laparoscopic atypical gastrectomy for gastric GIST is a safe and effective technique with good outcomes in experienced hands.

摘要

胃肠道间质瘤是胃肠道最常见的间叶性肿瘤。近年来,许多研究都涉及到这些肿瘤的腹腔镜治疗。本研究的目的是评估腹腔镜非典型胃切除术治疗这些肿瘤的安全性和有效性。在2009年1月至2015年12月期间,24例疑似胃GIST且肿瘤大小小于5 cm的患者接受了这种手术方式。排除腹膜和肝转移以及CD117抗原免疫组化表达作为纳入标准。我们回顾性分析了临床和组织病理学特征、手术结果、术后并发症和肿瘤学结果。统计分析纳入了14例患者。平均年龄为60岁(10名女性和4名男性),以上消化道出血为主要就诊主诉。1例患者需要转为开腹手术,未记录到重大并发症、再次入院或再次手术情况。平均肿瘤大小为41 mm,所有样本的切缘均为阴性。平均住院时间为3天,在44个月的随访中未记录到肿瘤复发情况。对于胃GIST,腹腔镜非典型胃切除术是一种安全有效的技术,在经验丰富的医生手中效果良好。

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