Department of Gastrointestinal Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230031, Anhui, China.
Department of Anesthesiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
BMC Surg. 2022 Jun 7;22(1):219. doi: 10.1186/s12893-022-01668-y.
Laparoscopic resection of gastric gastrointestinal stromal tumors (GISTs) is technically feasible and associated with favorable outcomes. We compared the clinical efficacy of hand-assisted laparoscopic surgery (HLS) and total laparoscopic surgery (TLS) for gastric GISTs.
We retrospectively analyzed the clinical data of 69 consecutive patients diagnosed with a gastric GIST in a tertiary referral teaching hospital from December 2016 to December 2020. Surgical outcomes were compared between two groups.
Fifty-three patients (TLS group: n = 36; HLS group: n = 17) were included. The mean age was 56.9 and 58.1 years in the TLS and HLS groups, respectively. The maximum tumor margin was significantly shorter in the HLS group than in the TLS group (2.3 ± 0.9. vs. 3.0 ± 0.8 cm; P = 0.004). The operative time of the HLS group was significantly shorter than that of the TLS group (70.6 ± 19.1 min vs. 134.4 ± 53.7 min; P < 0.001). The HLS group had less intraoperative blood loss, a shorter time to first flatus, and a shorter time to fluid diet than the TLS group (P < 0.05). No significant difference was found between the groups in the incidence or severity of complications within 30 days after surgery. Recurrence or metastasis occurred in four cases (HLS group; n = 1; TLS group; n = 3).
This study demonstrated that compared with TLS, HLS for gastric GISTs has the advantages of simpler operation, shorter operative time, and faster postoperative recovery.
腹腔镜胃胃肠间质瘤（GIST）切除术在技术上是可行的，并且具有良好的效果。我们比较了手辅助腹腔镜手术（HLS）和全腹腔镜手术（TLS）治疗胃 GIST 的临床疗效。
我们回顾性分析了 2016 年 12 月至 2020 年 12 月在一家三级转诊教学医院诊断为胃 GIST 的 69 例连续患者的临床资料。比较了两组的手术结果。
共有 53 例患者（TLS 组：n=36；HLS 组：n=17）入组。TLS 组和 HLS 组患者的平均年龄分别为 56.9 和 58.1 岁。HLS 组的最大肿瘤切缘明显短于 TLS 组（2.3±0.9cm vs. 3.0±0.8cm；P=0.004）。HLS 组的手术时间明显短于 TLS 组（70.6±19.1min vs. 134.4±53.7min；P<0.001）。HLS 组术中出血量、首次排气时间和开始液体饮食时间均明显少于 TLS 组（P<0.05）。两组术后 30 天内并发症的发生率或严重程度无显著差异。4 例（HLS 组：n=1；TLS 组：n=3）复发或转移。
与 TLS 相比，HLS 治疗胃 GIST 具有操作简单、手术时间短、术后恢复快等优点。
