3D腹腔镜手术治疗长径大于5 cm且小于等于10 cm胃间质瘤的疗效分析

Clinical analysis of gastric stromal tumors with diameter greater than 5 cm and no more than 10 cm treated by 3D laparoscopic surgery

关键词:  胃间质瘤  3D腹腔镜  开腹手术

Key words:  gastrointestinal stromal tumor  surgery  3D laparoscopy  open surgery

摘要:

目的 分析3D腹腔镜手术治疗长径大于5 cm且小于等于10 cm的胃间质瘤的安全性、可行性。方法 回顾性分析2014年1月至2017年2月在大连医科大学附属第二医院胃肠外科行手术治疗的长径大于5 cm且小于等于10 cm的43例胃间质瘤患者的临床资料。其中15例行开腹手术（开腹组），28例行3D腹腔镜手术（3D腹腔镜组）。比较两组患者的术中相关指标、术后恢复情况、术后病理及随访资料。结果 两组患者的手术时间、手术切除范围、术后并发症、肿瘤长径、核分裂像数目、术后复发的危险度分级、无复发生存时间情况比较，差异均无统计学意义（P>0.05）。相比开腹组，3D腹腔镜组术中出血量更少（P<0.05）；术后排气时间和进流食时间更早（P=0.013、P=0.007），住院时间更短（P=0.001），差异有统计学意义。结论 相比开腹手术，3D腹腔镜胃间质瘤手术出血量更少、术后恢复更快，且不增加术后并发症和远期复发比率。3D腹腔镜手术治疗长径大于5 cm小于等于10 cm的胃间质瘤安全、可行。

Abstract:

Objective To analyze the safety and feasibility of 3D laparoscopic surgery for gastric stromal tumors with diameter greater than 5 cm and no more than 10 cm. Methods The clinical data of 43 patients with gastric stromal tumors with diameter greater than 5 cm and no more than 10 cm was analyzed retrospectively from January 2014 to February 2017 at the Second Affiliated Hospital of Dalian Medical University. Among them, 15 patients were assigned into open group and 28 patients into 3D laparoscopic group. The clinical and prognostic survival data were collected and analyzed. Results There were no significant differences in operation time, scope of surgical resection, postoperative complications, tumor diameter, number of mitotic figures, risk classification of postoperative recurrence, and recurrence-free survival between open group and 3D laparoscopic group. Compared with the open group, the amount of bleeding in the 3D laparoscopic group was less (P<0.05), the postoperative exhaust time and the intake time were earlier (P=0.013, P=0.007). The hospitalization was shorter (P=0.001). Conclusions 3D laparoscopic surgery has less bleeding, faster postoperative recovery, and does not increase postoperative complications, long-term recurrence and metastasis rates compared with open surgery in the treatment of gastric stromal tumors. 3D laparoscopic surgery is safe and feasible in the treatment of gastric stromal tumors with a diameter greater than 5 cm and no more than 10 cm.