CAJ | 학술논문

目的通过与腹腔镜治疗有效性和安全性的对比,探讨无腹腔镜辅助下内镜切除胃间质瘤的临床应用价值.方法回顾性收集肿瘤直径＜3.0 cm且边界清晰的胃间质瘤患者92例,其中53例独立行内镜下切除(内镜组),39例独立行腹腔镜切除(腹腔镜组),对比分析2组手术耗时、术中出血量、术后胃管留置时间、术后通便时间、术后住院时间、术后并发症、复发率和转移率.结果内镜组与腹腔镜组比较,手术耗时短[50(48～58) min比70(50～95) min,U=1575.00,P＜0.01],术中出血量少[10(5～15)ml比20(20～30)ml,U=1794.00,P＜0.01],术后通便早[18(8～36)h比24(20 ～40)h,U=1666.00,P＜0.01],而在术后胃管留置时间、术后住院时间、术后并发症等方面差异均无统计学意义(P＞0.05).内镜组术后随访(27±15)个月,腹腔镜组术后随访(24±11)个月,2组随访时间差异无统计学意义(t=0.3084,P＞0.05),随访期间均未见胃间质瘤复发和转移,亦无因胃间质瘤而死亡的病例.结论对于直径＜3.0 cm且边界清晰的胃间质瘤行内镜下独立切除是安全可行的,与腹腔镜手术疗效相近,且创伤更小、恢复更快.
목적 통과여복강경치료유효성화안전성적대비,탐토무복강경보조하내경절제위간질류적림상응용개치.방법 회고성수집종류직경＜3.0 cm차변계청석적위간질류환자92례,기중53례독립행내경하절제(내경조),39례독립행복강경절제(복강경조),대비분석2조수술모시、술중출혈량、술후위관류치시간、술후통편시간、술후주원시간、술후병발증、복발솔화전이솔.결과 내경조여복강경조비교,수술모시단[50(48～58) min비70(50～95) min,U=1575.00,P＜0.01],술중출혈량소[10(5～15)ml비20(20～30)ml,U=1794.00,P＜0.01],술후통편조[18(8～36)h비24(20 ～40)h,U=1666.00,P＜0.01],이재술후위관류치시간、술후주원시간、술후병발증등방면차이균무통계학의의(P＞0.05).내경조술후수방(27±15)개월,복강경조술후수방(24±11)개월,2조수방시간차이무통계학의의(t=0.3084,P＞0.05),수방기간균미견위간질류복발화전이,역무인위간질류이사망적병례.결론 대우직경＜3.0 cm차변계청석적위간질류행내경하독립절제시안전가행적,여복강경수술료효상근,차창상경소、회복경쾌.
Objective To compare the feasibility and safety of endoscopy with laparoscopy and without for gastric stromal tumor.Methods A retrospective and comprehensive analysis was made based on the clinical data of endoscopic (53 cases) and laparoscopic (39 cases) resection for gastric stromal tumor (diameter ＜ 3 cm with clear boundary),by comparing the operation time,intraoperative blood loss,indwelling time of postoperative gastric tube,recovery time of bowel functions,postoperative complications,hospitalization time,metastasis,recurrence rate.Results Compared with the laparoscopic group,the endoscopic group required shorter operation time [50(48-58) min VS 70 (50-95) min,U =1575.00,P ＜ 0.01],less intraoperative blood loss [10 (5-15) ml VS 20 (20-30) ml,U =1794.00,P ＜ 0.01],earlier recovery of bowel functions [18 (8-36) h VS 24 (20-40) h,U =1666.00,P ＜ 0.01],hospitalization time,indwelling time of the postoperative gastric tube and postoperative complications showed no statistical difference (P ＞ 0.05).The postoperative follow-up time were (27 + 15) and (24 + 11) months in the endoscopic and laparoscopic group,respectively (t =0.3084,P ＞ 0.05).During the follow-up,no tumor recurrence or distant metastasis was discovered,nor was death of gastric stromal tumor.Conclusion Endoscopy without the assist of laparoscopy for the gastric stromal tumor,whose diameter is less than 3 cm with clear boundary,is safe and less invasive,and leads to quick recovery.