Qiao Qiao, Tu Huiming, Fei Bojian, Xu Kebin, Yang Fan, Li Jie, Gao Qizhong
Department of Gastroenterology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214062, China.
Department of Laparoscopic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 214062, China.
Gastroenterol Res Pract. 2022 May 25;2022:9963126. doi: 10.1155/2022/9963126. eCollection 2022.
To compare the effectiveness and safety of endoscopic closure and laparoscopic repair for gastric wall defection.
The clinical data of 120 patients with submucosal tumours enrolled at our hospital between January 2014 and December 2019 were retrospectively analysed. Patients were divided into two groups according to the surgery they underwent: an endoscopic closure group ( = 60) and a laparoscopic repair group ( = 60). The clinical characteristics, perioperative complications, and postoperative follow-up results of the two groups were analysed.
The surgery time in the endoscopic closure group was 56.20 ± 11.25 minutes, which was significantly lower compared with that in the laparoscopic repair group (159.35 ± 23.18 minutes; < 0.001). In addition, the postoperative stay in the endoscopic closure group was shorter than that in the laparoscopic repair group, and the intraoperative bleeding volume and incidence of enteral nutrition initiation after surgery were significantly lower. Medical expenses were also significantly lower in the endoscopic closure group than in the laparoscopic repair group ( < 0.001). Only one patient developed a postoperative fever in the endoscopic closure group; three patients developed a postoperative fever and one patient had postoperative bleeding in the laparoscopic repair group. However, there were no statistical differences between the two groups regarding the incidence of R0 resection, postoperative fever, postoperative bleeding, and closure failure (all > 0.05). There were no local recurrences, distant metastases, or deaths in either of the groups during the two-year follow-up period.
Non-laparoscopic-assisted surgery may be quicker, safer, and more effective for gastric wall defection.
比较内镜下闭合术与腹腔镜修补术治疗胃壁缺损的有效性和安全性。
回顾性分析2014年1月至2019年12月在我院收治的120例黏膜下肿瘤患者的临床资料。根据患者接受的手术方式将其分为两组：内镜下闭合组（n = 60）和腹腔镜修补组（n = 60）。分析两组患者的临床特征、围手术期并发症及术后随访结果。
内镜下闭合组手术时间为56.20±11.25分钟，显著低于腹腔镜修补组（159.35±23.18分钟；P<0.001）。此外，内镜下闭合组术后住院时间短于腹腔镜修补组，术中出血量及术后肠内营养开始时间显著更低。内镜下闭合组医疗费用也显著低于腹腔镜修补组（P<0.001）。内镜下闭合组仅1例患者术后发热；腹腔镜修补组3例患者术后发热，1例患者术后出血。然而，两组在R0切除率、术后发热、术后出血及闭合失败发生率方面无统计学差异（均P>0.05）。在两年随访期内，两组均无局部复发、远处转移或死亡病例。
非腹腔镜辅助手术治疗胃壁缺损可能更快、更安全且更有效。
