CAJ | 학술논문

目的：探讨腹腔镜与传统开腹手术治疗胃间质瘤的优缺点。方法分析2005－2014年间暨南大学第二临床医学院外科手术治疗的72例胃间质瘤患者的临床资料。根据手术方法的不同将72例患者分为腹腔镜手术组（n ＝35）和传统开腹手术组（n ＝37）。对2组患者的肿瘤直径、手术时间、术中出血量、术后进食时间、住院天数和手术费用等临床资料进行对比分析研究。结果腹腔镜组肿瘤直径为（3．8±0．6）cm，明显小于开腹组（5．3±1．2）cm；手术时间为（70．1±8．5）min，与开腹组（68．4±7．9）min 比较无显著性差异；术中出血量（40．0±5．5）ml，明显少于开腹组（100．8±20．1）ml；术后进食时间（23．6±3．3）h，明显早于开腹组（35．2±5．8）h；住院时间（5．5±1．0）d，明显短于开腹组（8．2±1．3）d；手术费用方面，腹腔镜组和开腹组分别为（36099±141）元和（33276±126）元，两者无明显差别。结论腹腔镜胃间质瘤手术具有创伤小、术中出血量少、术后进食时间早、住院时间短等优点；但对于直径大于5 cm 的胃间质瘤而言，选择开腹手术较为安全、合理。
목적：탐토복강경여전통개복수술치료위간질류적우결점。방법분석2005－2014년간기남대학제이림상의학원외과수술치료적72례위간질류환자적림상자료。근거수술방법적불동장72례환자분위복강경수술조（n ＝35）화전통개복수술조（n ＝37）。대2조환자적종류직경、수술시간、술중출혈량、술후진식시간、주원천수화수술비용등림상자료진행대비분석연구。결과복강경조종류직경위（3．8±0．6）cm，명현소우개복조（5．3±1．2）cm；수술시간위（70．1±8．5）min，여개복조（68．4±7．9）min 비교무현저성차이；술중출혈량（40．0±5．5）ml，명현소우개복조（100．8±20．1）ml；술후진식시간（23．6±3．3）h，명현조우개복조（35．2±5．8）h；주원시간（5．5±1．0）d，명현단우개복조（8．2±1．3）d；수술비용방면，복강경조화개복조분별위（36099±141）원화（33276±126）원，량자무명현차별。결론복강경위간질류수술구유창상소、술중출혈량소、술후진식시간조、주원시간단등우점；단대우직경대우5 cm 적위간질류이언，선택개복수술교위안전、합리。
Objective To compare the advantages and disadvantages of the laparoscope and conventional laparotomy for gastrointestinal stromal tumors(GIST).Methods Clinical data of 72 cases of GIST were retrospectively analyzed .According to surgical methods,they were divided into laparoscopic surgery group (n =35) and traditional open surgery group (n =37).Tumor diameter,operation time,intraoperative blood loss,postoperative eating time,hospitalization days and surgery cost between the 2 groups were comparatively analyzed.Results Tumor diameter in the laparoscopic group was (3.8 ±0.6) cm,which was smaller than that of the open surgery group (5.3 ±1.2) cm;operation time in the laparoscopic group was (70.1 ±8.5) min,which had no significant difference compared with that of the open surgery group (68.4 ±7.9) min;intraoperative blood loss in the laparo-scopic group was (40.0 ±5.5)ml,which was obviously less than that of the open surgery group (100.8 ±20.1) ml;postopera-tive eating time in the laparoscopic group was (23.6 ±3.3) h,which was obviously shorter than that of the open surgery group (35.2 ±5.8) h;hospitalization days in the laparoscopic group was (5.5 ±1.0) d,which was obviously shorter than that of the open surgery group (8.2 ±1.3) d;surgical cost in the laparoscopic group was (36099 ±141) yuan and that of the open surgery group was (33276 ±126) yuan,there had no significant difference .Conclusion Laparoscopic gastric surgery has the advantages of smaller trauma,less intraoperative blood loss,earlier postoperative eating time and shorter hospitalization time .But for GIST with diameter more than 5 cm,open surgery is safer and more reasonable .