He Bin, Yan Su, Li Rui, Qiu Hongqing, Tu Jianchen
Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, China.
J BUON. 2018 May-Jun;23(3):820-825.
The purpose of this study was to analyze the clinical efficacy and complications of endoscopic submucosal dissection (ESD) and laparoscopic resection of stromal tumors, and to explore the clinical value and complications of stromal tumors treated with ESD.
146 patients with gastric stromal tumors (GSTs) treated in our hospital from January 2012 to January 2016 were retrospectively analyzed. Patients were divided into the ESD group and the laparoscopic surgery group (LS). The operation time, postoperative recovery time of diet, postoperative exhaust time, etc were observed and analyzed. All the measurement indexes were described as mean ± standard deviation. The t-test of two independent samples was used for the hypothesis test. Chi-square test was used for comparison of the percent data between the two groups and p<0.05 indicated significant difference.
The postoperative diet recovery time, postoperative exhaust time, hospital stay and hospitalization cost of the ESD group were better compared with the LS group (p<0.001). There was no significant difference in operative time between the ESD and LS group (p>0.05), while the operation time in ESD group was longer than in the LS group (p<0.05). The operation time of gastric body and antrum stromal tumors was shorter than in the ESD group group (p<0.05). There were no significant differences in tumor diameter, mitotic number and Flether classification between the groups (p>0.05). No significant difference in the incidence of postoperative bleeding, incision infection and recurrence rate was noticeable between the groups (p>0.05).
Endoscopic treatment of GSTs is safe and feasible, and may be better than laparoscopic resection.
本研究旨在分析内镜黏膜下剥离术（ESD）和腹腔镜切除胃间质瘤的临床疗效及并发症，并探讨ESD治疗胃间质瘤的临床价值及并发症。
回顾性分析2012年1月至2016年1月在我院接受治疗的146例胃间质瘤（GST）患者。将患者分为ESD组和腹腔镜手术组（LS）。观察并分析手术时间、术后饮食恢复时间、术后排气时间等。所有测量指标均以均值±标准差表示。采用两独立样本t检验进行假设检验。采用卡方检验比较两组间的百分比数据，p<0.05表示差异有统计学意义。
ESD组术后饮食恢复时间、术后排气时间、住院时间和住院费用均优于LS组（p<0.001）。ESD组与LS组手术时间差异无统计学意义（p>0.05），但ESD组手术时间长于LS组（p<0.05）。胃体和胃窦间质瘤的手术时间短于ESD组（p<0.05）。两组间肿瘤直径、核分裂象数和弗莱彻分类差异无统计学意义（p>0.05）。两组术后出血、切口感染发生率及复发率差异无统计学意义（p>0.05）。
内镜治疗GSTs安全可行，可能优于腹腔镜切除术。
