腹腔镜与胃镜联合技术治疗46例胃胃肠间质瘤

目的探讨腹腔镜与胃镜联合技术治疗胃胃肠间质瘤（GIST）的可行性和安全性。方法对上海交通大学医学院附属仁济医院普通外科2009年6月至2011年6月间接受双镜联合手术治疗的46例胃GIST患者的临床资料进行回顾性分析。结果46例病例中男27例,女19例．平均年龄58．5岁：33例行胃镜辅助腹腔镜胃楔形切除术．13例行腹腔镜辅助胃镜手术。手术均获成功,无中转开腹和手术死亡病例。手术时间（85．5±29．3）rain,术中出血量（31．4±12．2）ml,术后胃肠功能恢复时间（31．6±14．9）h,术后住院（5．1±2．9）d。术后肿瘤生物学危险行为评估：极低度危险34例,低度危险12例。无术后并发症出现。随访2～26（中位随访12．6）个月,未见肿瘤复发和远处转移。结论双镜联合技术治疗胃GIST安全可行,具有微创、恢复快的特点,近期疗效满意。

Clinical analysis of laparoscopic and endoscopic cooperative surgery in the treatment of gastric gastrointestinal stromal tumor: report of 46 cases

Objective To evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery for treating gastric gastrointestinal stromal tumors （GIST）. Methods Retrospective analysis was performed on the clinical data of 46 patients with gastric GIST undergoing laparoscopic and endoscopic cooperative surgery between June 2009 and June 2011 at the Renji Hospital of Shanghai Jiaotong University School of Medicine. Results There were 27 males and 19 females with the mean age of 58.5 years. Thirty-three patients received endoscopy-assisted wedge resection, and 13 cases received laparoscopy-assisted endoscopic resection. All the operations were successful. The mean operative time was （85.5±29.3） min, the mean blood loss was （31.4±12.2） ml, the mean post- operative gastrointestinal functional recovery time was （31.6±14.9） h, and the mean post-operative hospital stay was （5.1±2.9）d. No post-operative complication occurred. NIH risk assessment showed that 34 cases were very low risk and 12 low risk. No recurrence or metastasis was found during the follow-up ranging from 2 to 26 months （median, 12.6 months）. Conclusion Laparoscopic and endoscopic cooperative surgery for gastric GIST is both feasible and safe with minimal invasiveness, fast recovery and satisfactory short-term outcomes.