胃间质瘤腹腔镜切除与开放手术疗效对比研究

目的：比较胃间质瘤（GST）腹腔镜切除和开放手术方法的效果及预后。方法回顾性分析2008年6月至2013年3月收治的胃间质瘤患者63例，其中37例采用腹腔镜切除（腹腔镜组），26例为传统开放手术切除（开放组），分析对比两组患者临床病理特征、手术情况及随访资料等。结果（1）腹腔镜组手术时间为（60.7±16.6）min，明显短于开放组的（127.7±31.3）min （t=11.023）；腹腔镜组的胃管拔出时间短于开放组[（2.6±0.7）d vs（5.6±1.1）d，t=13.231]，术中出血量更少[（56.8±10.0）ml vs（104.4±21.2）ml，t=11.927]，住院时间更短[（5.8±0.8）d vs（10.9±1.4）d， t=18.339]，差异均有统计学意义（P〈0.01）。（2）腹腔镜组患者中位生存期为56.3个月，开放组中位生存期为48.6个月。Log-Rank检验显示组间差异有统计学意义（P〈0.05）；腹腔镜组患者无复发，开放组无复发生存率85.0%，组间差异有统计学意义（P=0.039）。结论相对于开放手术，腹腔镜胃间质瘤切除具有手术时间短、住院时间短、复发率低等优势。

Comparative study of laparoscopic resection of gastric stromal tumor versus open surgery

Objective To evaluate the effect and prognosis of laparoscopic versus open resection of gastric stromal tumor（GST） . Methods Clinicopathological and follow-up data of sixty-three primary GST patients admitted to our hospital between June 2008 and March 2013 were analyzed retrospectively. Thirty-seven patients were treated with laparoscopic resections （LAP group） and 26 patients with traditional resections （open group）. Results （1） Operation time of LAP group was （60.7±16.6） min, significantly shorter than the open group （127.7±31.3） min （t=11.023）. Compared to the open group, the gastric tube pulling out time of LAP group was shorter [（2.6±0.7） d vs （5.6±1.1） d, t=13.231];the amount of bleeding was less[（56.8±10.0） ml vs （104.4±21.2） ml,t=11.927], hospitalization time was less [（5.8±0.8） dvs（10.9±1.4） d,t=18.339], all differences were statistically significant（P〈0.01）. （2） The median survival time of LAP group was 56.3 months, and that of the open group was 48.6 months; Log-Rank test showed that there was statistical significance between the two groups （P〈0.05）. There was no recurrence in LAP group, the recurrence-free survival of open group was 85.0%, the difference was statistically significant （P=0.039）. Conculsion Compared to open surgery, laparoscopic resection of GSTs shows shorter operation time and hospital stay, and lower recurrence rate.