腹腔镜手术治疗直肠间质瘤16例临床分析

目的 探讨腹腔镜下切除直肠间质瘤的可行性及安全性.方法 2013年5月-2016年12月在我科接受行腹腔镜直肠间质瘤切除术的患者共16例,其中男性10例、女性6例,肿瘤直径均小于5 cm.肿瘤下缘距肛缘大于5cm者行腹腔镜下直肠前切除术(Dixon术),肿瘤下缘距肛缘小于5cm且大于3cm者行腹腔镜下局部切除术,肿瘤下缘距肛缘小于3 cm且与周边组织界限不清者则行腹腔镜下腹会阴联合切除术(Miles术).结果 16例直肠间质瘤患者均在腹腔镜下成功切除肿瘤,无一例中转开腹手术,无术后穿孔、出血、梗阻、吻合口漏等并发症发生.其中,12例行腹腔镜下直肠前切除术(Dixon术),3例行腹腔镜下局部切除术,1例行腹腔镜下腹会阴联合切除术(Miles术).平均手术时间(103,0±23.8)m in,平均住院时间(7.0±1.2)d,平均术中出血(14.0±4.1)mL.术后病理证实为间质瘤,切缘阴性.随访8～40个月,无一例患者复发.2例患者肿瘤转移至肝脏,并最终死于肝转移.结论 腹腔镜下直肠间质瘤切除是安全、可行的,手术创伤小,住院时间短,术后恢复快.

Laparoscopic surgery for rectal stromal tumor: a report of 16 cases

Objective To evaluate the feasibility and safety of laparoscopic resection of rectal stromal tumors (GIST). Methods the clinical data of laparoscopic resection of rectal stromal tumors in our department from May 2013 to December -2016 were analyzed retrospectively. Results 16 cases of rectal stromal tumors were successfully removed under laparoscope.,no conversion to laparotomy, Of these, 12 underwent Dixon, 3 underwent local resection, and 1 underwent Miles. The average operative time was 103 minutes (65-146 minutes), the average length of stay was 7 days (5-9 days). the average intraoperative blood loss was 14ml (5-20ml) . Postoperative pathology confirmed the diagnosis of stromal tumors, negative margins..The patients were followed up for 8-40 months, there was no recurrence, 2 cases were transferred to the liver, and 1 cases died of liver metastasis.Conclusion laparoscopic resection of rectal stromal tumors is safe and feasible, with less trauma, shorter hospitalization time and quicker postoperative recovery.