腹腔镜与开腹胃胃肠间质瘤楔形切除术的临床对比研究

目的比较腹腔镜与开腹胃胃肠间质瘤（GIST）楔形切除术的临床疗效。方法回顾性分析浙江省人民医院2000年6月至2009年8月间行手术切除并经术后病理证实的48例胃GIST患者的临床资料。手术采用腹腔镜或开腹胃楔形切除术．其中腹腔镜组18例,开腹组30例。比较两组患者围手术期情况及预后。结果与开腹组相比,腹腔镜组手术时间延长,术中出血量减少,术后使用镇痛比例降低．术后恢复进食时间及肛门排气提前,术后住院时间缩短（均P〈0．05）。两组均无手术死亡病例,腹腔镜组术后并发症发生率为5．5％（1／18）．明显低于开腹组的33．3％（10／30）,差异有统计学意义（P〈0．05）。两组术后复发率分别为11．8（2／17）和10．7％（3／28）：5年生存率分别为78％和63％,差异均无统计学意义（均P〉0．05）。结论腹腔镜胃GIST楔形切除术疗效确切且安全可行。

Laparoscopic versus open wedge resection for gastrointestinal stromal tumors of the stomach: a clinical controlled study

Objective To compare the surgical outcomes between laparoscopic and open wedge resection for gastrointestinal stromal tumors of the stomach. Methods Clinical data of 18 cases undergoing laparoseopic wedge resection from June 2000 to August 2009 at the Zhejiang Provincial People＇s Hospital were compared with 30 patients treated by open surgery. The perioperative parameters and prognosis data of the two groups were compared. Results Compared to the open group, laparoscopic group was found with longer operative time, less blood loss, less requirement of postoperative analgesia, earlier resumption of oral intake, earlier return of first flatus, and shorter postoperative hospital stay（all P〈0.05）. There were no postoperative deaths in both groups. Postoperative complication rate was significantly /ower in the laparoscopic group （5.5% vs. 33.3%, P〈0.05）. The postoperative recurrence rates were 11.8%（2/17） and 10.7%（3/28）; the 5-year survival rates were 78% and 63%, respectively, and the difference was not statistically significant （P〉0.05）. Conclusion Laparoscopic wedge resection is a feasible treatment option for GISTs of the stomach.