腹腔镜结合胃镜治疗胃间质瘤的临床应用

目的探讨腹腔镜结合胃镜治疗胃间质瘤的临床可行性和安全性。方法回顾分析本科2008年3月至2011年10月行腹腔镜结合胃镜治疗胃间质瘤的16例患者临床资料,其中14例行胃镜辅助下腹腔镜胃楔形切除术,1例在胃镜辅助下行腹腔镜胃腔内肿瘤切除术,1例行腹腔镜辅助下胃镜肿瘤切除术。结果 16例患者均完成手术,无中转开腹和手术并发症发生。手术时间(80.3±23.7)min,术中出血(20.4±11.6)ml,术后住院(5.6±2.1)d。切除的肿瘤直径为1.3～2.7 cm,术后免疫组化结果:CD117阳性12例(75.0%),CD34阳性9例(56.2%),其中极低度风险11例,低度风险5例,无高危病例。结论腹腔镜结合胃镜治疗胃间质瘤安全可行。

Gastroscopic-assisted laparoscopic resection in treatment of gastric stromal tumors

Objective To investigate the feasibility and safety of gastroscopic-assisted laparoscopic resection in treatment of gastric stromal tumors.Methods The clinical data of 16 patients with gastric stromal tumors treated with gastroscopic-assisted laparoscopic resection from Mar.2008 to Oct.2011 were analyzed.Fourteen patients were treated by gastroscopic-assisted laparoscopic wedge resection,1 patient was treated by gastroscopic-assisted laparoscopic transluminal resection,and 1 patient was treated by laparoscopic-assisted gastroscopic resection.Results All the operations were successful,and no peritoneotomy conversion and complication occurred.The operation time was(80.3±23.7) min,the blood loss during operation was(20.4±11.6) ml,and the postoperative hospital stay was(5.6±2.1) d.The resected tumor was 1.3 to 2.7 cm in diameter.The immunohistochemical results showed that 12 patients were CD117-positive(75.0%) and 9 patients were CD34-positive(56.2%).There were 11 patients with extremely low risk,5 patients with low risk and no patient with high risk.Conclusion Gastroscopic-assisted laparoscopic resection in treatment of gastric stromal tumors is safe and feasible,but its long-term effect need to be further analyzed.