胃间质瘤经腹腔镜与开腹手术治疗效果的临床对照研究

目的探讨腹腔镜胃间质瘤切除术较传统开腹手术的治疗效果、安全性。方法28例胃间质瘤患者分别采用经腹腔镜或常规开腹手术行胃间质瘤切除术，主要比较两组的术后并发症、早期复发情况，并以此推测两种术式在手术安全性的优劣。结果手术时间腹腔镜手术组为（100．7±24．8）min，开腹手术组（95．0±22．4）min，差异无统计学意义（P〉0．05）；术中失血量腹腔镜手术组为（56．4±18．1）ml，（83．9±27．3）ml，差异有统计学意义（P〈0．05）；术后排气时间腹腔镜手术组为（69．4±32．3）h，开腹手术组（104．6±20．7）h，P〈0．05，住院时间腹腔镜手术组（8．8±1．8）d，开腹组为（11．4±1．5）d，P〈0．05；术后并发症腹腔镜组1例，开腹组2例，P〉0．05。随访期内（6～24个月）Kaplan—Meier生存分析差异无统计学意义（P〉0．05）。结论在熟练掌握腹腔镜手术的基础上行胃间质瘤切除术是安全的，且患者创伤小、康复快，治疗效果与开腹手术无差别。

A randomized controlled trial:Laparoscopic surgery versus open surgery for the treatment of gastric stromal tumor

Objective To explore the clinical efficacy of laparoscopic resection of gastric stromal tumor versus open resection, and assess the feasibility and effectiveness of the laparoscopic approach. Methods A total of 28 patients with gastric stromal tumors were divided into 2 groups ： laparoscopy group and open resection group. Postoperative complications and recurrence were compared between the two groups. Results There was no significant difference in postoperative complications and recurrence be- tween the two groups. The operation time in the laparoscopy group was （ 100.7 ± 24.8 ） min, similar to that in the open resection group（95.0 ±22.4） min （P 〉 0.05 ）. The blood loss in the laparoscopy group was （ 56.4 ± 18.1 ） ml, significantly less than that in the open resection group （ 83.9 ± 27.3 ） ml （ P 〈 0.05 ）. The exhaust time after the operation and the length of hospital stay in the laparoscopy group were（69.4 ± 32.3 ） h and （ 8. 8 v 1.8 ） d respectively, significantly shorter than those in the open resection group （ 104.6 ± 20.7 ） h and （ 11.4 ± 1.5 ） d ] （ P 〈 0.05 ）. Postoperative complications and short - term cumu- lative survival rates of the 2 groups had no significant difference （ P 〈 0. 05 ）. Conclusion Laparoscopic resection of gastric stromal tumors can be performed safely and effectively in patients with gastric stromal tumor with the advantage of minimal invasiveness and good clinical efficacy.