CAJ | 학술논문

目的比较腹腔镜与开腹胃胃肠间质瘤(GIST)楔形切除术的临床疗效。方法回顾性分析浙江省人民医院2000年6月至2009年8月间行手术切除并经术后病理证实的48例胃GIST患者的临床资料。手术采用腹腔镜或开腹胃楔形切除术，其中腹腔镜组18例，开腹组30例。比较两组患者围手术期情况及预后。结果与开腹组相比，腹腔镜组手术时间延长，术中出血量减少,术后使用镇痛比例降低，术后恢复进食时间及肛门排气提前，术后住院时间缩短（均P＜0.05）。两组均无手术死亡病例，腹腔镜组术后并发症发生率为5.5％(1/18)，明显低于开腹组的33.3％(10/30)，差异有统计学意义（P＜0.05）。两组术后复发率分别为11.8(2/17)和10.7％(3/28);5年生存率分别为78％和63％,差异均无统计学意义（均P＞0.05）。结论腹腔镜胃GIST楔形切除术疗效确切且安全可行。
목적 비교복강경여개복위위장간질류(GIST)설형절제술적림상료효。방법 회고성분석절강성인민의원2000년6월지2009년8월간행수술절제병경술후병리증실적48례위GIST환자적림상자료。수술채용복강경혹개복위설형절제술，기중복강경조18례，개복조30례。비교량조환자위수술기정황급예후。결과 여개복조상비，복강경조수술시간연장，술중출혈량감소,술후사용진통비례강저，술후회복진식시간급항문배기제전，술후주원시간축단（균P＜0.05）。량조균무수술사망병례，복강경조술후병발증발생솔위5.5％(1/18)，명현저우개복조적33.3％(10/30)，차이유통계학의의（P＜0.05）。량조술후복발솔분별위11.8(2/17)화10.7％(3/28);5년생존솔분별위78％화63％,차이균무통계학의의（균P＞0.05）。결론 복강경위GIST설형절제술료효학절차안전가행。
Objective To compare the surgical outcomes between laparoscopic and open wedge resection for gastrointestinal stromal tumors of the stomach. Methods Clinical data of 18 cases undergoing laparoscopic wedge resection from June 2000 to August 2009 at the Zhejiang Provincial People's Hospital were compared with 30 patients treated by open surgery. The perioperative parameters and prognosis data of the two groups were compared. Results Compared to the open group,laparoscopic group was found with longer operative time, less blood loss, less requirement of postoperative analgesia, earlier resumption of oral intake, earlier return of first flatus, and shorter postoperative hospital stay(all P＜0.05). There were no postoperative deaths in both groups. Postoperative complication rate was significantly lower in the laparoscopic group (5.5％ vs. 33.3％, P＜0.05). The postoperative recurrence rates were 11.8％ (2/17) and 10.7％(3/28); the 5-year survival rates were 78％ and 63％, respectively, and the difference was not statistically significant (P＞0.05). Conclusion Laparoscopic wedge resection is a feasible treatment option for GISTs of the stomach.