Hajer Jan, Havlůj Lukáš, Kocián Petr, Klimbacher Günther, Shamiyeh Andreas, Gürlich Robert, Whitley Adam
Second Department of Internal Medicine, Third Faculty of Medicine, Charles University and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic.
Department of Surgery, Third Faculty of Medicine, Charles University and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic.
Gastroenterol Res Pract. 2019 Jul 1;2019:7573031. doi: 10.1155/2019/7573031. eCollection 2019.
The aim of this study was to compare the indications, operative details, and clinical outcomes of nonexposed endoscopic wall-inversion surgery with endoscopic-navigated laparoscopic wedge resection of gastric submucosal tumours.
Medical records were reviewed for patients who underwent nonexposed endoscopic wall-inversion surgery (NEWS) at the Faculty Hospital Kralovske Vinohrady and endoscopic-navigated laparoscopic wedge resection (LWR) at the Kepler University Hospital. Demographic, tumour, surgical, perioperative, and follow-up data were collected and compared.
Eleven patients underwent NEWS and twelve patients underwent LWR. NEWS was associated with a longer operating time and more frequent suture line bleeding (3 cases in the NEWS group versus 1 case in the LWR group). Negative resection margins were achieved in all NEWS procedures and in 11 of the LWRs. The difference in size between the tumour and the resected specimen was smaller in the NEWS group. Length of hospitalisation was similar between the two groups (NEWS = 6.8 days, LWR = 6.5 days). Follow-up gastroscopies at 12 months postoperatively revealed no signs of recurrence in any of the patients.
Nonexposed endoscopic wall-inversion surgery is a new technique for the treatment of gastric tumours. It allows for more precise resections with more frequent achievement of negative resection margins than LWRs. Additionally, it may allow for better preservation of gastric function and limit communication between the gastric lumen and peritoneal cavity. The longer operating time and more frequent complications associated with the NEWS reflects the limited experience with these new techniques.
本研究旨在比较非暴露式内镜壁翻转手术与内镜导航腹腔镜楔形切除术治疗胃黏膜下肿瘤的适应症、手术细节及临床结果。
回顾了在克拉洛夫斯基维诺赫拉迪大学医院接受非暴露式内镜壁翻转手术（NEWS）以及在开普勒大学医院接受内镜导航腹腔镜楔形切除术（LWR）的患者的病历。收集并比较了患者的人口统计学、肿瘤、手术、围手术期及随访数据。
11例患者接受了NEWS，12例患者接受了LWR。NEWS的手术时间更长，缝合线出血更频繁（NEWS组3例，LWR组1例）。所有NEWS手术及11例LWR手术均实现了切缘阴性。NEWS组肿瘤与切除标本的大小差异更小。两组的住院时间相似（NEWS =6.8天，LWR =6.5天）。术后12个月的随访胃镜检查显示，所有患者均无复发迹象。
非暴露式内镜壁翻转手术是一种治疗胃肿瘤的新技术。与LWR相比，它能实现更精确的切除，切缘阴性的达成率更高。此外，它可能有助于更好地保留胃功能，并限制胃腔与腹腔之间的连通。与NEWS相关的较长手术时间和更频繁的并发症反映了这些新技术的经验有限。
