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1.
J. Buyske M. McDonald C. Fernandez J. L. Munson L. E. Sanders J. Tsao D. H. Birkett 《Surgical endoscopy》1997,11(11):1084-1087
Background: Benign gastric tumors and tumors of low-grade malignancy can be safely removed laparoscopically.
Methods: Seven patients were considered candidates for laparoscopic resection of gastric tumors. Inclusion criteria included small
tumor size (less than 6 cm), exophytic or endophytic tumor morphology, and benign characteristics. Indications for surgical
intervention included bleeding, weight loss, and need for tissue diagnosis. Patients ranged in age from 38 to 70. There were
five female and two male patients. All patients underwent preoperative upper GI endoscopy. The procedures were performed using
a four- or five-port technique. An Endo-GIA (US Surgical Company, Norwalk, Connecticut) was used to amputate those tumors
located on the serosal surface of the stomach. Tumors on the mucosal surface were exposed via a gastrotomy, then likewise
amputated using an Endo-GIA. The gastrotomy closure was then either hand sewn or stapled. Operating time ranged from 95 to
225 min.
Results: Final pathologic diagnoses included lipoma, lymphoma, leiomyoma, and leiomyosarcoma. There was a 28% conversion rate. There
were no complications. Length of postoperative stay ranged from 4 to 7 days. There have been no tumor recurrences in 6–38-month
follow-up.
Conclusions: Minimally invasive management of benign and low-grade gastric tumors can be performed safely with excellent short- and long-term
results.
Received: 17 March 1997/Accepted: 28 May 1997 相似文献
2.
Minimally invasive parathyroid surgery 总被引:3,自引:0,他引:3
Background: Minimally invasive access for the treatment of primary hyperparathyroidism is becoming widespread, but several different
approaches have been proposed in the literature.
Methods: We describe the three main types of mini-invasive parathyroidectomy, with particular attention to the gasless video-assisted
procedure, which is now routinely performed at our institution.
Results: Eighty-nine patients with a preoperatively localized single adenoma were successfully treated. Operative time was 58 mins,
and there were only five conversions. Discussion: After comparing the different approaches described in literature, we conclude that mini-invasive parathyroidectomy is feasible
and can provide additional benefits not available with traditional surgery. At present, however, this operation can be recommended
only for patients with sporadic disease, localized lesions, and absence of goiter and prior neck surgery.
Received: 8 August 1999/Accepted: 13 December 2000/Online publication: 14 September 2000 相似文献
3.
Laparoscopic treatment of gastric stromal tumors 总被引:9,自引:4,他引:5
Basso N Rosato P De Leo A Picconi T Trentino P Fantini A Silecchia G 《Surgical endoscopy》2000,14(6):524-526
Background: The laparoscopic resection of gastric stromal tumors (GST) is being performed with increased frequency.
Methods: Between November 1993 and October 1998, nine consecutive patients with benign and low-grade gastric stromal tumors underwent
laparoscopic resection using intraoperative endoscopy. For lesions located on the anterior wall (three cases), a direct approach
was utilized. Lesions located on the posterior wall were resected via a transgastric approach (four cases) or through a small
opening on the omentum or on the gastrocolic ligament (two cases). Excision of the lesions was performed manually by means
of electrocautery and scissors in eight cases; the gastric incisions were closed by manual running suture. An endoscopic stapler
device was used in one case only.
Results: All patients were successfully treated laparoscopically; there were no conversions to open surgery. Operative time ranged
from 75 to 120 min. There was one bleeding from the suture line of the gastric wall postoperatively that was treated conservatively.
The average postoperative hospital stay was 4 days (range, 2–6).
Conclusions: In light of the results reported in the literature and on the basis of the present work, it seems that laparoscopic resection
of GST should be considered as the treatment of choice. Wedge resection of anterior wall lesions is generally performed. The
treatment of posterior wall lesions is still controversial. In our opinion the direct approach should be reserved for lesions
located on the posterior wall of the body, which can be easily reached through the greater omentum, while the transgastric
approach should be preferred for lesions located on the fundus and antrum. Manual excision allows a tailored operation; hand-sewn
sutures are always feasible, and they are cheaper than stapled ones.
Received: 30 April 1999/Accepted: 7 October 1999/Online publication: 10 April 2000 相似文献
4.
Minimally invasive surgical staging for esophageal cancer 总被引:9,自引:0,他引:9
Luketich JD Meehan M Nguyen NT Christie N Weigel T Yousem S Keenan RJ Schauer PR 《Surgical endoscopy》2000,14(8):700-702
Background: The incidence of esophageal adenocarcinoma is increasing in the United States, and the 5-year survival rate is dismal. Preliminary
data suggest that conventional imaging is inaccurate in staging esophageal cancer and could limit accurate assessment of new
treatments. The objective of this study was to compare minimally invasive surgical staging (MIS) with conventional imaging
for staging esophageal cancer.
Methods: Patients with potentially resectable esophageal cancer were eligible. Staging by conventional methods used computed tomography
(CT) scan of the chest and abdomen, and endoscopic ultrasound (EUS), whereas MIS used laparoscopy and videothoracoscopy. Conventional
staging results were compared to those from MIS.
Results: In 53 patients, the following stages were assigned by CT scan and EUS: carcinoma in situ (CIS; n= 1), I (n= 1), II (n= 23), III (n= 20), IV (n= 8). In 17 patients (32.1%), MIS demonstrated inaccuracies in the conventional imaging, reassigning a lower stage in 10 patients
and a more advanced stage in 7 patients.
Conclusions: In 32.1% of patients with esophageal cancer, MIS changed the stage originally assigned by CT scan and EUS. Therefore, MIS
should be applied to evaluate the accuracy of new noninvasive imaging methods and to assess new therapies for esophageal cancer.
Received: 5 April 1999/Accepted: 15 March 2000/Online publication: 12 July 2000 相似文献
5.
Outcomes assessment and minimally invasive surgery 总被引:2,自引:0,他引:2
Archer SB Sims MM Giklich R Traverso B Laycock B Wolfe BM Apfelgren KN Fitzgibbons RJ Hunter JG 《Surgical endoscopy》2000,14(10):883-890
Background: Outcomes assessment is being used increasingly to shape practice patterns in all areas of medicine. Although outcomes assessment
is not a new concept, the widespread application of outcomes measurement for modifying practice is novel. Instead of focusing
on results of interventions in highly controlled environments, outcomes studies usually report results as they occur in uncontrolled,
real-world environments. Recently, the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) has initiated a society-wide
initiative to monitor outcomes in patients undergoing various laparoscopic operations.
Methods: Pertinent literature is reviewed as it relates to outcomes assessment. The historical background underpinning the modern
interest in outcomes is outlined. Definitions of terms useful for understanding outcomes research are given. The impact of
outcomes assessment on minimally invasive surgery, both positive and negative, are examined. The SAGES outcome initiative
is introduced.
Conclusions: Although outcomes studies usually do not provide information on the causes of observations made, they have gained in popularity
because they provide information about patient perceptions of disease, disability, and treatment. Minimally invasive surgical
procedures often are reported in terms of outcomes assessment because a controlled clinical trial was rendered impossible
by early and widespread application of laparoscopic surgery. The SAGES outcomes initiative will provide the necessary tools
for the participation of surgeons in the process of practice profiling.
Received: 17 December 1999/Accepted: 4 April 2000/Online publication: 29 August 2000 相似文献
6.
Lessons learned from laparoscopic treatment of gastric and gastroesophageal junction stromal cell tumors 总被引:4,自引:0,他引:4
Background Stromal cell tumors of the gastric and gastroesophageal junction are rare neoplasms that traditionally have been resected
for negative margins using an open approach. This study aimed to evaluate the efficacy laparoscopic resection of gastric and
gastroesophageal stromal cell tumors and the lessons learned from experience with this method.
Methods This retrospective review evaluated all patients who underwent laparoscopic resection of gastric or esophageal stromal cell
tumors at a tertiary referral center between December 2002 and March 2005. Medical records were reviewed with regard to patient
demographics, preoperative evaluation, operative approach, tumor location and pathology, length of operation, complications,
and length of hospital stay.
Results A total of 12 consecutive patients with a mean age of 55 ± 5.9 years were treated. Preoperative endoscopic ultrasound (EUS)
was performed for 11 of 12 patients with a diagnostic accuracy of 100%, whereas EUS-guided fine-needle aspiration was performed
for 10 of 12 patients with a diagnostic accuracy of 50%. Four patients with symptomatic gastroesophageal junction leiomyomas
were treated with enucleation and Nissen fundoplication. Eight patients were treated with laparoscopic wedge resection of
gastric lesions. Complete R0 resection was achieved for all the patients undergoing laparoscopic resection. Intraoperative
endoscopy was performed for four patients and resulted in shorter operative times. The average operative time for this entire
series was 169 ± 17 min: 199 ± 24 min for the first six cases and 138 ± 19 min for the last six cases. The median hospital
length of stay was 2 days. One patient with esophageal leiomyoma had persistent dysphagia at the 12-month follow-up assessment.
There were no other complications and no deaths in this series of patients.
Conclusions Laparoscopic resection of gastric and gastroesophageal junction stromal cell tumors may be performed safely with low patient
morbidity. This approach can achieve adequate surgical margins and lead to short hospital stays. Improvements in the technique
have led to shorter operative times.
Presented at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) meeting, Ft. Lauderdale, Florida, 15
April 2005 相似文献
7.
Minimally invasive pancreatic surgery 总被引:2,自引:0,他引:2
Melvin WS 《American journal of surgery》2003,186(3):274-278
Robotic surgery remains in its infancy, and little experience has been reported, as surgeons carefully explore the application of this type of technology to diseases of the pancreas. While challenging and controversial, Dr. Zollinger would most likely support the ongoing research in the techniques of pancreatic surgery that can lead only to an improvement in the outcomes of our patients. 相似文献
8.
Background: Minimally invasive surgery (MIS) is an ideal way to obtain biopsy specimens in children with cancer. We examined the safety,
reliability and outcome of decisions made based on tissue obtained using MIS.
Methods: Fifty-nine oncology patients underwent 62 MIS procedures between January 1994 and July 1998. Complications, biopsy results,
and outcomes were reviewed.
Results: The study population comprised 32 boys and 27 girls, with an average age of 8.8 years. There were 47 thoracoscopic and 15
laparoscopic operations. Laparoscopic procedures included initial biopsy, determination of resectability, and second-look
exam. Thoracoscopic procedures included 40 lung biopsies and seven biopsies/resections of mediastinal masses. Diagnostic accuracy
was 100% in all cases. No patient was found retrospectively to have been inadequately treated based on decisions made from
tissue obtained by MIS.
Conclusion: MIS is a safe and accurate means of obtaining tissue in pediatric oncology patients. Treatment decisions can be made accurately
and with confidence using these techniques.
Received: 19 March 1999/Accepted: 27 August 1999 相似文献
9.
R. Avrahami I. Nudelman S. Watenberg O. Lando Y. Hiss S. Lelchuk 《Surgical endoscopy》1998,12(5):466-468
Axillary dissection is the major cause of morbidity in breast cancer and primary cutaneous melanoma of the extremity. In
the present study, we examine the potential benefits and advantages of endoscopic axillary lymph node dissection over conventional
surgery. Twenty endoscopic axillary dissections and 10 lymph node samplings were performed in 10 cadavers (four male, six
female). A preperitoneal distention balloon (PDB) system was used to dissect the axilla. In four of the cadavers, the procedure
was followed by open surgery. The axillary contents were examined for lymphatic tissue by a pathologist. The endoscopic technique
offered easy access to the axilla and clear visualization of the axillary vein, as well as the long thoracic and thoracodorsal
nerves. Results were comparable to those achieved with the classic surgical dissection. Endoscopy is feasible for axillary
lymph node dissection and sampling in cases of breast cancer and primary cutaneous melanoma of the extremity. Further studies
in patients are needed to reach definitive conclusions.
Received: 31 December 1996/Accepted: 12 September 1997 相似文献
10.
Minimally invasive surgery (MIS), or laparoscopic surgery, plays a vital role in residency training in a number of surgical disciplines including general surgery, surgical oncology, colorectal surgery, pediatric surgery, and thoracic surgery. The tremendous patient demand for MIS over the past 2 decades has resulted in surgeons rapidly embracing this technique. Many general surgery residencies cover basic laparoscopy within their residency program; however, the experience with more advanced cases is more variable. This career resource guides the interested medical student and physician to opportunities for fellowship training in MIS. It includes a discussion of the specialty, training requirements, grant funding, research fellowships, and pertinent societies. 相似文献
11.
Transgastrostomal endoscopic surgery for early gastric carcinoma and submucosal tumor 总被引:3,自引:1,他引:2
Background: Laparoscopic intraluminal surgery of the stomach is now widely used for a lesion on the posterior wall. However, this procedure
has some technical limitation related to the intricate introduction of the surgical instruments into the gastric lumen. In
this article, we report our newly developed technique of transgastrostomal endoscopic surgery that overcomes this limitation
and is also suitable for full-thickness gastric wall resection of a lesion in the wall.
Methods: After making a 4-cm-long temporary gastrostomy, a Buess-type endoscope is inserted into the gastric lumen through the gastrostomy.
The operation is performed inside the gastric lumen under video camera guidance using electrocautery, scissors, and forceps.
After resection, the wound in the mucosa or the wound after full-thickness resection is endoluminally sutured. Mucosal resection
was performed in six cases of early gastric carcinoma, two cases of atypical epithelium, and one case of ectopic pancreas.
Full-thickness wall resection was performed in four cases of a leiomyoma.
Results: In all 13 cases, the lesion could be precisely located by the video camera. All lesions were then resected endoluminally.
The mean duration of the operation was 148 min. The postoperative course in all cases was uneventful.
Conclusions: Transgastrostomal endoscopic surgery is minimally invasive and an efficient tissue-preserving technique for the removal of
early gastric carcinoma or submucosal tumor.
Received: 7 September 1996/Accepted: 27 January 1997 相似文献
12.
I-Rue Lai M.D. Ph.D. Wei-Jei Lee M.D. Ph.D. Sen-Chang Yu M.D. Ph.D. 《Journal of gastrointestinal surgery》2006,10(4):563-566
Laparoscopic wedge resection of the stomach (LWS) has become the treatment of choice for patients with benign gastric tumors.
The technical consideration and long-term follow-up data of LWS for gastrointestinal stromal tumors (GISTs) of the stomach
are limited. We present our experience of 28 LWSs for gastric GISTs with a mean follow-up of 43 months. From October 1995
to December 2002, we successfully performed 28 LWSs for 29 patients with GISTs of the stomach, and one patient needed conversion
to laparotomy because of suspected bowel injury when establishing pneumoperitoneum. Patient demographics, perioperative parameters,
and outcomes of the 28 patients were assessed retrospectively. The tumors were located in the upper third of the stomach in
13 patients, in the middle third, in eight patients, and in the lower third, in seven patients. The mean size of tumors was
3.4 ± 1.6 cm in diameter. The duration of operation ranged from 95 to 390 minutes: 189.6 ± 79.5 minutes with the stapler method
and 194.3 ± 50.5 minutes with the hand-sewn method (P = 0.8870). No blood transfusion was given in the perioperative period in all cases. Cholecystectomy in three patients and
repair of hiatal hernia in one patient were performed during the same operation. The oral intake was restored at the third
to fourth postoperative days. The hospital stay ranged from 3 to 11 days (mean, 6.7 ± 1.8 days). The follow-up period ranged
from 12 to 95 months (mean, 43.3 ± 23.5 months, median 42 months). There has been no evidence of tumor recurrence, including
one patient with microscopic invasion of section margin. LWS can be performed safely with a satisfactory remission rate for
patients with gastric stromal cell tumors.
Presented at the 94th Annual Meeting of the Surgical Association of Taiwan, March 27, 2005, Tao-Uan, Taiwan. 相似文献
13.
目的 评价胃肠间质瘤的临床诊断及行腹腔镜手术治疗的可行性与安全性.方法 回顾性分析2006年8月-2009年6月43例超声内镜拟诊胃肠道间质瘤的临床诊断与治疗资料.结果 腹腔镜手术成功36例,成功率为83.7%.超声内镜诊断率为69.O%.术后诊断胃肠道间质瘤免疫组化CD117、CD34标记阳性率为100%.术后患者平均住院时间为5 d,术后疼痛轻微.结论 超声内镜及CD117、CD34标记可以作为胃肠道间质瘤临床影像学诊断及免疫学诊断的重要手段,腹腔镜手术切除胃肠间质瘤是安全可行的. 相似文献
14.
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。 相似文献
15.
Background: One of the more difficult tasks in surgical education is to teach the optimal application of instrument forces and torques
necessary to facilitate the conduct of an operation. For laparoscopic surgery, this type of training has traditionally taken
place in the operating room, reducing operating room efficiency and potentially affecting the safe conduct of the operation.
The objective of the current study was to measure and compare forces and torques (F/T) applied at the tool/hand interface
generated during laparoscopic surgery by novice (NS) and experienced (ES) surgeons using an instrumented laparoscopic grasper
and to use this data for evaluating the skill level.
Methods: Ten surgeons (five-NS, five-ES) performed a cholecystectomy and Nissen fundoplication in a porcine model. An instrumented
laparoscopic grasper with interchangeable standard surgical tips equipped with a three-axis F/T sensor located at the proximal
end of the grasper tube was used to measure the F/T at the hand/tool interface. In addition, one axis force sensor located
at the grasper's handle was used to measure the grasping force. F/T data synchronized with visual view of the tool operative
maneuvers were collected simultaneously via a novel graphic user interface incorporated picture-in-picture video technology.
Subsequent frame-by-frame video analysis of the operation allowed a definition of states associated with different tool/tissue
interactions within each step of the operation. F/T measured within each state were further analyzed using vector quantization
(VQ). The VQ analysis defines characteristic sets of F/T in the database that were defined as F/T signature.
Results: The magnitude of F/T applied by NS and ES were significantly different (p < 0.05) and varied based on the task being performed. Higher F/T magnitudes were applied by NS than by ES when performing
tissue manipulation, whereas lower F/T magnitudes were applied by NS than by ES during tissue dissection. Furthermore, the
time to complete the surgical procedure was longer for NS by a factor of 1.5–4.8 when compared to the time for ES. State analysis
suggests that most of this time is consumed in an [idle] state, in which movements of the surgeon make no tissue contact.
Conclusions: Preliminary data suggest that F/T magnitudes associated with the tool/tissue interactions provide an objective means of distinguishing
novices from skilled surgeons. Clinical F/T analysis using the proposed technology and methodology may be helpful in training,
developing surgical simulators, and measuring technical proficiency during laparoscopic surgery.
Received: 4 May 1999/Accepted: 1 April 2000/Online publication: 4 August 2000 相似文献
16.
Summary
Background: Minimally invasive adrenalectomy is the standard procedure for the treatment of small benign adrenal neoplasms. The question
of whether this technique is also suitable for treating adrenal malignancies has recently been discussed with controversy.
Methods: A literature search was performed to gather published experience and opinions concerning the role of endoscopic adrenalectomy
in the treatment of primary adrenal malignancies and adrenal metastases.
Results: Adrenocortical carcinomas (ACCs) have been approached laparoscopically, and this technique has even been advocated for large
tumours. Several small ACCs have been successfully removed laparoscopically. Oncological catastrophes with peritoneal carcinomatosis
have been reported. Reoperation after laparoscopic adrenalectomy for unsuspected ACC was usually not performed. There are
no data demonstrating a survival benefit of systematic lymphadenectomy. Adrenal metastases are firm and rarely penetrate the
capsule of the adrenal gland. Several reports on endoscopic adrenalectomy for metastases have been published.
Conclusions: Laparoscopic adrenalectomy for ACC should be considered with great reluctance. If ACC is diagnosed postoperatively upon
histological examination after laparoscopic adrenalectomy for a presumably benign tumour, reoperation is not mandatory provided
oncological principles were respected during the primary operation. Adrenal metastases confined to the adrenal gland can be
removed laparoscopically.
相似文献
17.
18.
Indications for endo-organ gastric excision 总被引:1,自引:0,他引:1
Intragastric surgery for benign and malignant conditions is a new form of minimally invasive surgery, to which the term endo-organ
gastric surgery has been applied. This procedure may provide improved results for patients, but reported studies are small,
and follow-up evaluation is limited. The indications for endo-organ surgery are evolving as technology and operative expertise
begin to meet the need for continued advancements in miniaturized surgery. This new approach is applied primarily to the removal
of gastric neoplasms poorly positioned or too large for standard transoral endoscopic excision. Gastric polyps, benign gastric
wall tumors such as leiomyomas and carcinoids, and low-grade as well as high-grade malignancies can be removed. The history
of endo-organ surgery, the background technology, and surgical experience are reviewed. In addition, current indications for
endo-organ surgery and the rationale for algorithms are included. Intraluminal gastric surgery is not widely performed or
studied, therefore a further understanding of its role is provided.
Received: 7 April 1999/Accepted: 18 August 1999 相似文献
19.
Background: In 1995, when we first used a high-definition television (HDTV) video system during a laparoscopic cholecystectomy in Tuebingen,
we were surprised by the excellence of the spatial impression achieved by an image with improved resolution. Although any
improvement in vision systems entails a trade-off among cost, quality, and complexity, high-definition imaging may well become
an essential part of 3-D video systems. The aim of this experimental study was to assess the impact of high definition on
surgical task efficiency in minimally invasive surgery and to determine whether it is preferable to use a 3-D system or a
2-D system with perfect resolution and color—for instance, HDTV or the three-chip charge-coupled device (3CCD).
Methods: We compared a 3-D video system with the vision through a stereoscopic rectoscope for transanal endoscopic microsurgery (TEM).
Because its stereoscopic direct vision is not restricted to either shutter technology or video resolution, TEM optics represents
the state of the art. For objective comparison, inanimate phantom models with suturing tasks were set up. The setups allowed
the approach of parallel instruments as in TEM operations or via a laparoscopic approach, with oblique instruments coming
laterally. Both types of procedure were carried out by highly experienced laparoscopic surgeons as well as those inexperienced
in endoscopic surgery. These volunteers worked under 3-D video vision and/or TEM vision. Altogether, the model tasks were
performed by 54 different persons.
Results: The evaluation did not show a significant (p > 0.05) difference in performance time in all models, but there was a clear trend showing the benefit of a higher resolution.
Conclusion: We found a tendency for both endoscopically inexperienced and experienced surgeons to benefit from the use of a system with
improved resolution (direct vision) rather than a 3-D shutter video system.
Received: 9 November 1998/Accepted: 19 April 1999 相似文献
20.
Laparoscopic vs open resection of gastric stromal tumors 总被引:18,自引:3,他引:18
Matthews BD Walsh RM Kercher KW Sing RF Pratt BL Answini GA Heniford BT 《Surgical endoscopy》2002,16(5):803-807
Background: Gastric stromal tumors are rare neoplasms that may be benign or malignant. Given that malignant gastric stromal
tumors rarely involve lymph nodes and require excision with negative margins, they appear amendable to laparoscopic excision.
There are few reports of laparoscopic resection, and no comparisons have been done between laparoscopic and open surgery.
This study compares the relative efficacy of the two approaches. Methods: Between May 1994 and December 2000, 33 patients
underwent 35 operations for gastric stromal tumors. Laparoscopic resections were performed in 21 patients; open resections
were done in 12 patients. The medical records of the patients were reviewed retrospectively with regard to operating time,
blood loss, length of stay, and clinical course. Results: Patient demographics, tumor characteristics (mean tumor size, benign
vs malignant), and presenting symptoms were similar for both groups. In the laparoscopic group, 15 wedge resections; three
partial gastrectomies, and three transgastric needlescopic enucleations were performed. In the open group, six vedge resections,
four antrectomies, and two partial proximal gastrectomies were performed. There were no significant differences in mean operative
time (169 vs 160 min), mean estimated blood loss (106 vs 129 cc), or perioperative complication rate (9.5% vs 8.3%) between
the laparoscopic and open groups, respectively. The mean length of stay was significantly less (p<0.05) in the laparoscopic
group (3.8 vs 6.2 days). Average follow-up was 1.5 years. One patient in each group has died due to metastastic disease. There
have been no trocar site recurrences. Conclusions: Laparoscopic resection of gastric stromal tumors is safe and appropriate.
Tumor size, operating time, and estimated blood loss were equivalent to the open approach, and there was a statistically shorter
hospital stay in the laparoscopic group. 相似文献