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目的:探讨腹腔镜手术治疗胃间质瘤的可行性及安全性。方法:收集胃间质瘤患者110例,其中行腹腔镜胃间质瘤切除术50例(腔镜组),60例(开腹组)进行开腹手术,对比分析两组患者肿瘤的大小、手术时间、术中出血、术后进食时间、住院时间、术后并发症等临床资料。结果:两组比较:性别、年龄、主要症状、肿瘤部位、手术方式等一般资料与开腹组比较无统计学差异(P>0.05)。腔镜组与开腹组比较:手术时间缩短(119.7±12.5min与159.6±20.3min,P=0.041)、术中出血量明显减少(42.1±10.3ml与150.7±21.1ml,P=0.032)减少,术后排气时间(24.21±10.5h与48.1±8.5h,P=0.031),术后住院时间明显缩短(6.21±1.5d与8.7±1.32d,P=0.0472),肿瘤直径小(3.7±0.5cm与5.7±0.6cm,P=0.007),总住院费用(6.21±1.5万元与8.7±1.32万元,P=0.0472)与开腹组比较差异有统计学意义(P<0.05);术后腔镜组有3例出现并发症,开腹2例出现并发症,与开腹组比较差异无统计学意义(P>0.05)。腹腔镜组和开腹组随访时间分别为(12~24个月),腔镜组和开腹组各有1例高危病人出现复发。结论对于肿瘤体积较小,腹腔镜手术治疗胃间质瘤是安全可行,且术后恢复快,对于肿瘤直径大于5cm的间质瘤腔镜切除仍是安全可行的。
Objective: To investigate the feasibility and safety of laparoscopic surgery for the treatment of gastric stromal tumors. Methods: One hundred and ten patients with gastric stromal tumor were collected, including 50 cases of laparoscopic gastric stromal tumor (laparoscopic group) and 60 cases of laparotomy group (open group). The tumor size, Operation time, intraoperative bleeding, postoperative eating time, hospital stay, postoperative complications and other clinical data. Results: There was no significant difference between the two groups in general information such as gender, age, major symptoms, tumor location, operation method and laparotomy group (P> 0.05). Compared with laparotomy, laparoscopic group showed shorter operative time (119.7 ± 12.5min vs 159.6 ± 20.3min, P = 0.041) and a significant decrease in intraoperative bleeding (42.1 ± 10.3ml vs 150.7 ± 21.1ml, P = 0.032) , Postoperative exhaust time (24.21 ± 10.5h and 48.1 ± 8.5h, P = 0.031), postoperative hospitalization time was significantly shorter (6.21 ± 1.5d vs 8.7 ± 1.32d, P = 0.0472) 0.5cm and 5.7 ± 0.6cm, P = 0.007). The total hospitalization costs (6.21 ± 1.5 and 8.7 ± 1.32, respectively, P = 0.0472) were significantly different from those in the open group (P <0.05) There were 3 complications in the posterior endoscopy group and 2 complications in the open surgery group. There was no significant difference between the two groups (P> 0.05). Laparoscopic group and open group follow-up time was (12 to 24 months), laparoscopic group and open group, one case of high-risk patients relapse. Conclusion It is safe and feasible for laparoscopic surgery to treat gastric stromal tumors with small tumor volume and rapid recovery after surgery. It is safe and feasible to perform endoscopic resection of stromal tumor with tumor diameter greater than 5 cm.