中国继续医学教育
中國繼續醫學教育
중국계속의학교육
China Continuing Medical Education
2015年
23期
98-99
,共2页
胃肠间质瘤%腹腔镜%局部切除
胃腸間質瘤%腹腔鏡%跼部切除
위장간질류%복강경%국부절제
Gastrointestinal stromal tumors%Laparoscope%Local resection
目的 探讨腹腔镜下胃局部切除治疗胃间质瘤的可行性和中短期疗效.方法 回顾性分析在我院接受腹腔镜下胃局部切除手术的43例胃间质瘤患者的临床病理资料.结果 根据肿瘤部位和生长方式行腹腔镜胃楔形切除术34例,腹腔镜经胃前壁胃局部切除术6例,腹腔镜经胃前壁肿瘤外翻切除术3例.肿瘤直径(3.38±0.81)cm,核分裂象(3.14±1.77/50)HPF,手术时间(60.93±13.87)min,术中出血量(49.54±35.74)ml.术后胃肠功能恢复时间(2.98±0.51)d,术后住院时间(7.40±1.40)d.术后消化道内出血1例,腹腔内感染1例,切口感染1例,均经保守治疗后好转.术后随访1~69月,平均(30.91±17.60)月,1例中危患者,术后未口服格列卫辅助治疗,术后25个月后出现肝脏转移,余病例未见局部复发及远处转移.结论 选择合适的病例行腹腔镜下胃局部切除治疗胃间质瘤,中短期疗效确切且安全可行.
目的 探討腹腔鏡下胃跼部切除治療胃間質瘤的可行性和中短期療效.方法 迴顧性分析在我院接受腹腔鏡下胃跼部切除手術的43例胃間質瘤患者的臨床病理資料.結果 根據腫瘤部位和生長方式行腹腔鏡胃楔形切除術34例,腹腔鏡經胃前壁胃跼部切除術6例,腹腔鏡經胃前壁腫瘤外翻切除術3例.腫瘤直徑(3.38±0.81)cm,覈分裂象(3.14±1.77/50)HPF,手術時間(60.93±13.87)min,術中齣血量(49.54±35.74)ml.術後胃腸功能恢複時間(2.98±0.51)d,術後住院時間(7.40±1.40)d.術後消化道內齣血1例,腹腔內感染1例,切口感染1例,均經保守治療後好轉.術後隨訪1~69月,平均(30.91±17.60)月,1例中危患者,術後未口服格列衛輔助治療,術後25箇月後齣現肝髒轉移,餘病例未見跼部複髮及遠處轉移.結論 選擇閤適的病例行腹腔鏡下胃跼部切除治療胃間質瘤,中短期療效確切且安全可行.
목적 탐토복강경하위국부절제치료위간질류적가행성화중단기료효.방법 회고성분석재아원접수복강경하위국부절제수술적43례위간질류환자적림상병리자료.결과 근거종류부위화생장방식행복강경위설형절제술34례,복강경경위전벽위국부절제술6례,복강경경위전벽종류외번절제술3례.종류직경(3.38±0.81)cm,핵분렬상(3.14±1.77/50)HPF,수술시간(60.93±13.87)min,술중출혈량(49.54±35.74)ml.술후위장공능회복시간(2.98±0.51)d,술후주원시간(7.40±1.40)d.술후소화도내출혈1례,복강내감염1례,절구감염1례,균경보수치료후호전.술후수방1~69월,평균(30.91±17.60)월,1례중위환자,술후미구복격렬위보조치료,술후25개월후출현간장전이,여병례미견국부복발급원처전이.결론 선택합괄적병례행복강경하위국부절제치료위간질류,중단기료효학절차안전가행.
Objective To investigate the feasibility, short and mid-term efficacy of laparoscopic local gastric resection for primary gastric GIST. Methods Clinicopathologic data of 43 patients with primary gastric GIST, undergoing laparoscopic local gastric resection in our hospital were retrospectively analyzed.Results According to tumor location and growth types, gastric wedge resection was performed in 34 cases, local gastric resection passing anterior gastric wall was performed in 6 cases, ectropion resection passing anterior gastric wall was performed in 3 cases. The mean diameter of tumors was ( 3.38±0.81 ) cm. The mean mitotic figures were ( 3.14±1.77/50 ) HPF. The mean operational time was ( 60.93±13.87 ) minutes, with a mean blood loss of ( 49.54±35.74 ) ml. Postoperative bowel function recovery time was ( 2.98±0.51 ) days and the length of postoperative hospital stay was ( 7.40±1.40 ) days. Postoperative digestive tract hemorrhage developed in 1 patient, abdominal infection developed in 1 patient, and wound infection developed in 1 patient. These were cases recovered by conservative therapy. After a follow-up ranging from 1 to 69months,the mean follow-up time was ( 30.91±17.60 ) months. Hepatic metastasis developed in 1 case, no local recurrence or death was found. Conclusion Laparoscopic local gastric resection for primary gastric GIST in selected patients is safe and feasible, with favorable short and mid-term efifcacy.
