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目的:探讨腹腔镜胃腔外楔形切除(ELWR)手术治疗胃间质瘤的可行性与安全性,并评估其肿瘤疗效及相关预后。方法:选择2005年3月—2012年9月ELWR手术治疗的49例胃间质瘤患者作为研究对象,患者术后均经病理诊断及CD117确诊。分别对患者的临床资料、围手术期情况及患者的长期随访结果进行分析。结果:患者年龄为(57.1±16.3)岁,其中女性25例。大多数肿块位于胃底部,且肿瘤大小(4.1±2.0)cm,30例(61.2%)处于极低或低危险度,仅2例为高危险度;除有23例(46.9%)出现腹痛、腹胀外,其余各例未见异常表现;手术时间为(101.9±15.4)min,无中转开腹手术、再次手术或严重手术并发症发生;在平均52个月(10~99个月)的随访中,分别有4例出现复发,2例出现转移并死亡,且经COX回归分析发现肿瘤的危险度分级是其预后的影响因素(P<0.05)。结论:对胃间质瘤患者施行ELWR手术有效、安全、微创,且结合术后靶向治疗具有良好的预后。
Objective: To investigate the feasibility and safety of laparoscopic gastric wedge resection (ELWR) in the treatment of gastric stromal tumors and evaluate its efficacy and prognosis. METHODS: Forty-nine patients with gastric stromal tumors treated with ELWR from March 2005 to September 2012 were selected as the study subjects. All patients were confirmed by pathological diagnosis and CD117 after operation. The patient’s clinical data, perioperative conditions and long-term follow-up of patients were analyzed. Results: The age of patients was (57.1 ± 16.3) years old, of which 25 were women. Most of the tumors were located at the base of the stomach with a tumor size of (4.1 ± 2.0) cm and 30 (61.2%) patients were at very low or low risk, with only 2 of them being at high risk; except 23 (46.9%) with abdominal pain , Abdominal distension, the rest of the cases showed no abnormalities; operation time was (101.9 ± 15.4) min, no laparotomy, reoperation or serious complications; in an average of 52 months (10 to 99 months) During the follow-up, 4 cases had recurrence respectively, 2 cases had metastasis and died, and the risk of tumor classification was the prognostic factor (P <0.05) by COX regression analysis. Conclusion: ELWR is an effective, safe and minimally invasive procedure for patients with gastric stromal tumors and has a good prognosis in combination with postoperative targeted therapy.