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目的:评估腹腔镜手术切除胃间质瘤的可行性及安全性。方法:收集2010年1月—2016年1月期间行胃间质瘤手术切除并符合研究条件的患者资料,将行腹腔镜手术与行开腹手术肿瘤位置相同的患者作1:1匹配,最终腹腔镜组与开腹组各纳入36例,比较两组患者的相关临床指标。结果:两组患者基本资料具有可比性。肿瘤位于近贲门处各5例,胃体小弯侧各12例,胃体(或胃底)各13例,近幽门处各6例。腹腔镜组与开腹组切除方式(楔形切除:26例vs.23例;胃部分切除:8例vs.10例)无明显差异(P>0.05)。与开腹组比较,腹腔镜平均手术时间、术中出血量减少(114 min vs.140 min;90 m L vs.138 m L);平均肛门排气时间、经口进流食时间、术后住院天数均减少(2.6 d vs.3.1 d;4.1 d vs.5.3 d;6.0 d vs.8.3 d);围手术期总并发症发生率降低(0.0%vs.16.7%),差异均有统计学意义(均P<0.05)。两组术后病理指标、复发率、总生存率、无病生存率差异均无统计学意义(均P>0.05)。结论:对于原发性胃间质瘤,腹腔镜手术安全有效,且在肿瘤位置相同的条件下,比开腹手术创伤小、并发症少、患者恢复快。
Objective: To evaluate the feasibility and safety of laparoscopic resection of gastric stromal tumor. Methods: The data of patients who undergone surgical resection of gastric stromal tumor from January 2010 to January 2016 were collected and matched with the research conditions. The patients who underwent laparoscopic surgery with the same tumor position undergoing laparotomy were matched for 1: 1, and finally Laparoscopic group and open group were included in 36 cases, comparing the two groups of patients with clinical indicators. Results: The basic data of two groups of patients were comparable. The tumors were located in 5 cases near the cardia, 12 cases in the lesser curvature side of the body, 13 cases in the stomach (or fundus) and 6 cases in the near pylorus. Laparoscopic group and open group resection method (wedge resection: 26 cases vs. 23 cases; partial resection of the stomach: 8 cases vs. 10 cases) showed no significant difference (P> 0.05). Compared with the open group, the average laparoscopic operation time and intraoperative blood loss decreased (114 min vs. 140 min; 90 m L vs. 138 m L); mean anal exhaust time, oral feeding time, postoperative hospital stay (2.6 d vs.3.1 d; 4.1 d vs.5.3 d; 6.0 d vs.8.3 d). The incidence of perioperative complications was lower (0.0% vs.16.7%), the differences were statistically significant (All P <0.05). There was no significant difference in the pathological parameters, recurrence rate, overall survival and disease-free survival between the two groups (all P> 0.05). Conclusion: For primary gastric stromal tumors, laparoscopic surgery is safe and effective, and under the same tumor location, trauma is less than the open surgery, the complications are less and the patients recover faster.