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腹腔镜与开放手术切除直径大于5厘米的胃胃肠道间质瘤:一项单中心回顾性研究

Laparoscopic Versus Open Resection of Gastric Gastrointestinal Stromal Tumors Larger Than 5 cm: A Single-Center, Retrospective Study.

作者信息

Qiu Guanglin, Wang Jing, Che Xiangming, He Shicai, Wei Chao, Li Xuqi, Pang Ke, Fan Lin

机构信息

1 The First Affiliated Hospital Medical College of Xi'an Jiaotong University, Shaanxi Province, China.

2 Baoji Central Hospital, Shaanxi Province, China.

出版信息

Surg Innov. 2017 Dec;24(6):582-589. doi: 10.1177/1553350617731402. Epub 2017 Sep 21.

Abstract

BACKGROUND

The technical feasibility and oncological safety of laparoscopic surgery for gastric gastrointestinal stromal tumors (GISTs) larger than 5 cm has not been adequately studied. Therefore, we performed this retrospective study to investigate the clinical outcomes of gastric GIST patients treated with laparoscopic surgery compared with those who underwent open surgery.

METHODS

We retrospectively evaluated the outcomes of 48 consecutive patients who underwent gastric resection for gastric GISTs larger than 5 cm. The patients were divided into 2 groups based on the surgery performed: the laparoscopic resection group (LAPG) and the open resection group (OG). We assessed all available patient data, including baseline information, tumor characteristics, surgical outcomes, pathological results, postoperative complications, and long-term patient survival.

RESULTS

The 2 groups had similar baseline data. No differences were found in tumor size, location, mitotic count, and risk grade according to Fletcher's risk classification. The LAPG was superior to the OG in blood loss, time to first flatus, time to oral intake, and length of postoperative hospital stay. Perioperative complications, recurrence rate, and long-term survival, however, did not differ significantly between the groups. The mean operation time in the LAPG was 28 minutes longer than that in the OG.

CONCLUSIONS

In patients with primary gastric GISTs larger than 5 cm, laparoscopic resection is a technically feasible and oncologically safe surgery when performed by experienced surgeons.

摘要

背景

对于直径大于5cm的胃胃肠道间质瘤(GIST),腹腔镜手术的技术可行性和肿瘤学安全性尚未得到充分研究。因此,我们进行了这项回顾性研究,以调查接受腹腔镜手术治疗的胃GIST患者与接受开放手术患者的临床结局。

方法

我们回顾性评估了48例连续接受胃切除手术治疗直径大于5cm胃GIST患者的结局。根据所进行的手术将患者分为两组:腹腔镜切除组(LAPG)和开放切除组(OG)。我们评估了所有可用的患者数据,包括基线信息、肿瘤特征、手术结局、病理结果、术后并发症和患者长期生存情况。

结果

两组的基线数据相似。根据弗莱彻风险分类,在肿瘤大小、位置、有丝分裂计数和风险等级方面未发现差异。LAPG在失血量、首次排气时间、开始经口进食时间和术后住院时间方面优于OG。然而,两组之间围手术期并发症、复发率和长期生存率无显著差异。LAPG的平均手术时间比OG长28分钟。

结论

对于原发性胃GIST直径大于5cm的患者,由经验丰富的外科医生进行腹腔镜切除是一种技术上可行且肿瘤学安全的手术。

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