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目的比较腹腔镜联合胃镜和同期开腹手术治疗胃间质瘤病例的治疗效果。方法回顾性分析2010年1月至2015年3月期间笔者所在医院施行腹腔镜联合胃镜治疗胃间质瘤的56例患者的临床资料,并与同期53例行开腹胃间质瘤手术病例进行对比分析;观察2组患者的一般资料、手术相关指标、手术并发症资料及随访结果。结果 2组患者的一般资料、术中情况、手术后总的并发症率、局部复发及远处转移比较差异均无统计学意义(P>0.05)。腹腔镜联合胃镜组术中发生肿瘤破裂1例,中转开腹1例;开腹组无肿瘤破裂者。2组无围手术期死亡病例,均未发生明显胃出血、吻合口狭窄、吻合口漏等并发症。与开腹组相比,腹腔镜联合胃镜组术中失血量及术后腹腔引流量明显减少,术后肛门排气时间、术后止痛剂使用时间及术后住院时间明显缩短,但住院总费用较高,手术时间较长,其差异有统计学意义(P<0.05)。结论在严格掌握适应证和丰富的开腹胃间质瘤手术经验和熟练的腹腔镜手术技术的基础上,腹腔镜联合胃镜治疗胃间质瘤,能取得与开腹手术同样的疗效,并具有出血少、恢复快等优势。
Objective To compare the therapeutic effects of laparoscopy combined with endoscopy and concurrent laparotomy on the treatment of gastric stromal tumors. Methods The clinical data of 56 patients with gastric stromal tumor treated by laparoscopy combined with gastroscope in our hospital from January 2010 to March 2015 were retrospectively analyzed and compared with 53 cases of open surgery of gastric gastric stromal tumors Contrast analysis; general information, operation related indicators, surgical complications and follow-up results of two groups were observed. Results There was no significant difference in general information, intraoperative status, total postoperative complications rate, local recurrence and distant metastasis between the two groups (P> 0.05). Laparoscopy combined gastroscopy group occurred in 1 case of tumor rupture, laparotomy in 1 case; open group without tumor rupture. No perioperative deaths occurred in 2 groups. No obvious complications such as gastric bleeding, anastomotic stenosis and anastomotic leakage occurred. Compared with the open group, laparoscopic combined gastroscopy group blood loss and postoperative abdominal drainage significantly reduced postoperative anal exhaust time, postoperative analgesic time and postoperative hospitalization was significantly shorter, but the total cost of hospitalization Higher, longer operation time, the difference was statistically significant (P <0.05). Conclusion Laparoscopy and gastroscopy for the treatment of gastric stromal tumors on the basis of strict indications and rich experience in laparoscopic surgery and open laparoscopic surgery, can achieve the same effect with open surgery, and has the advantages of Less bleeding, faster recovery and other advantages.