| 双镜联合技术在胃间质瘤治疗中的应用 |
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| 引用本文： | 贺思佳,;瞿春莹,;周敏,;沈峰,;张毅,;曹佳,;李永盛,;陈莺,;徐雷鸣.双镜联合技术在胃间质瘤治疗中的应用[J].中华消化内镜杂志,2014(12):699-702. |
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| 作者姓名： | 贺思佳 ;瞿春莹 ;周敏 ;沈峰 ;张毅 ;曹佳 ;李永盛 ;陈莺 ;徐雷鸣 |
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| 作者单位： | [1]上海交通大学医学院附属新华医院消化科内镜诊治部,上海200092; [2]上海交通大学医学院附属新华医院普外科,上海200092; |
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| 摘 要： | 目的探讨双镜联合（胃镜联合腹腔镜）治疗胃间质瘤的安全性和有效性。方法2010年至2013年间采用双镜联合、单纯胃镜、单纯腹腔镜、传统开腹手术治疗的胃间质瘤患者共107例，比较4种治疗方式的操作时间、术中出血量、术后胃肠道功能恢复时间、术后下床活动时间、术后住院时间，以及术后并发症发生和肿瘤复发情况。结果所有病例手术顺利，术后无死亡及治疗相关并发症，随访至今无复发。双镜联合组、单纯胃镜组，单纯腹腔镜组、传统开腹组肿瘤直径分别为（3．7±2．8）em、（2．1±1．2）em、（3．8±2．4）em和（4．2±2．6）em，操作时间分别为（1．8±1．0）h、（0．8±0．5）h、（2．4±1．0）h和（2．5±1．0）h，术中出血量分别为（39．4±42．7）ml、（35．0±37．2）ml、（59．3±54．6）ml和（236，7±332．2）ml，术后胃肠道功能恢复时间分别为（2．6±1．3）d、（0．5±0．1）d、（3．7±1．4）d和（5．3±2．4）d，术后下床活动时间分别为（0．5±0．1）d、（0．4±0．1）d、（0．6±0．2）d和（3．7±0．7）d，术后住院时间分别为（7．1±5．1）d、（2．0±1．8）d、（9．2±3．1）d和（11．5±4．0）d。双镜联合组操作时间、术后胃肠道功能恢复时间显著短于单纯腹腔镜组（P〈0．05），操作时间、术中出血量、术后胃肠道功能恢复时间、术后下床活动时间、术后住院时间均显著短于或少于传统开腹组（P〈0．05），肿瘤直径、操作时间、术后胃肠道功能恢复时间、术后下床活动时间、术后住院时间明显大于或长于单纯胃镜组（P〈0．05）。结论双镜联合治疗胃间质瘤安全可行，适用范围广，且创伤小、术后恢复快，近期疗效令人满意，其远期疗效仍需进一步随访。
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| 关 键 词： | 腹腔镜治疗 内镜治疗 双镜联合 胃间质瘤 |
Clinical application of endoscopy combined with laparoscopy to the treatment of gastric stromal tumors |
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| Institution: | He Sijia , Qu Chunying, Zhou Min, Shen Feng, Zhang Yi, Cao Jia, Li Yongsheng, Chen Ying, Xu Leiming (Department of Digestive Endoscopic Diagnosis and Treatment, Xinhua Hospital, Shanghai Jiao- tong University School of Medicine, Shanghai 200092, China) |
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| Abstract: | Objective To investigate the safety and feasibility of application of endoscopy combined with laparoscopy to the treatment of gastric stromal tumors. Methods Data of 107 patients with gastric stro- mal tumors, who underwent combination therapy, endoscopy only, laparoscopy only and laparotomy at Xin- hua Hospital Affiliated to Shanghai Jiaotong University School of Medicine between 2010 and 2013, were ret- rospectively analysed. The operation time, intraoperative bleeding volume, postoperative recovery time, gas- trointestinal function, postoperative ambulation time and postoperative hospital stay, complications and recur- rence after operation, were compared between different groups. Results The therapies were completed suc- cessfully without death or postoperative complications and no recurrence or metastasis was found. The diame- ters of tumor were （3.7 ± 2. 8 ） cm, （2. 1 ± 1.2） cm, （3.8 ± 2.4） cm and （4. 2 ± 2. 6） em in the combination group, endoscopy group, laparoscopy group and laparotomy group, respectively; the operation times were （ 1.8 ± 1.0） h, （0.8 ± 0.5 ） h, （ 2.4 ± 1.0） h and （ 2. 5 ± 1.0） h, respectively; the intraoperative blood loss were （ 39.4 ± 42. 7 ） ml, （ 35.0 ± 37.2） ml, （59. 3 ± 54. 6） ml, （236. 7 ± 332. 2） ml, respectively ; the recov- ery times of gastrointestinal function were （2. 6 ± 0.3 ） d, ±0. 5 ± 0.1） d, （3.7 ± 1.4） d, （5. 3 ± 2.4 ） d; thetimes of ambulation were （0. 5 -± 0. 1 ） d, （0. 4 ± 0. 1 ） d, （0. 6 -± 0. 2） d, and （3.7 ± 0.7 ） d ; and the postop- erative lengths of hospital stay were （7.1 ± 5.1 ） d, （2.0 ± 1.8 ） d, （ 9.2 ± 3.1 ） d and （ 11.5 ± 4.0 ） d, re- spectively. The operation time and recovery time of gastrointestinal function were significantly shorter in the combination group than those in the laparoseopy group（P 〈 0. 05 ） ;the operation time, blood loss, recovery time of gastrointestinal function, time of ambulation and postoperative length of |
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| Keywords: | Therapeutic laparoscopy Therapeutic endoscopy Endoscopy combined with lapa- roscopy Gastric stromal tumors |
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