改良腹腔镜经黏膜下隧道切除胃间质瘤临床分析

目的探讨改良腹腔镜经黏膜下隧道肿瘤切除术治疗固有肌层来源的胃间质瘤临床效果。方法回顾性分析2013年2月至2015年2月46例固有肌层来源的胃间质瘤患者临床资料,23例行改良腹腔镜下隧道肿瘤切除术(改良组),23例行内镜下全层切除术(对照组)。利用统计学软件SPSS19.0进行分析,其中住院时间,手术时间,术中出血量及腹痛时间等计量资料用均数±标准差(x珋±s)表示,组间比较用t检验;复发率及并发症发生率用(%)表示,组间比较用卡方检验,P0.05表示差异具有统计学意义。结果改良组手术时间,住院时间,腹痛时间、术中出血量均比对照组显著减少(P0.05);改良组术后总并发症2例(8.7%)显著低于对照组9例(39.1%),差异具有统计学意义(χ~2=4.301,P0.05);随访期间改良组复发1例,复发率为4.35%,远远低于对照组复发8例,复发率为34.78%,差异具有统计学意义(χ~2=4.973,P=0.026)。结论改良腹腔镜经黏膜下隧道肿瘤切除术应用于固有肌层来源的胃间质瘤患者成效显著,同时减少并发症和复发情况,具有良好的应用前景。

Clinical analysis of modified laparoscopic excision of tumors through the submucosal tunnel in the treatment of gastric stromal tumors

Objective To discuss the clinical efficacy of modified laparoscopic excision of tumors through the submucosal tunnel on the treatment of gastric stromal tumors of ntrinsic source . Methods The clinical data of 46 cases of patients with gastric stromal tumors of ntrinsic source in our hospital from February 2013 to February 2015 were retrospectively analyzed .There were 23 cases who were treated with modified laparoscopic excision of tumors through the submucosal tunnel ( as the modified group ) , and the other 23 cases were treated with endoscopic total resection ( as the control group ) .The total data were analyzed and processed by statistical software SPSS 19.0, among which the measurement data such as hospital stay, operation time, intraoperative blood loss and abdominal pain and so on were denoted by mean ±standard deviation (x±s).The comparison between the two groups were analyzed by t test, while the count data such as the number of patients with recurrence and complications were denoted by cases .The constituent ratios were denoted by %, and the comparison between the two groups was tested by Chi square . P<0.05 was thought to be statistically significant . Results The operative time, hospital stay, abdominal pain time, and intraoperative blood loss in the modified group were significantly decreased comparing with those in the control group (P<0.05).There were 2 cases with complications after operation (8.7%), which was significantly lower than 9 cases in the control group (39.1%).The difference was statistically significant (χ2 =4.301, P<0.05).There was 1 case with recurrence in the modified group during the follow-up period, and the recurrence rate was 4.35%, which was far lower than that in the control group with a recurrence rate of 34.78%.The difference was also statistically significant (χ2 =4.973, P =0.026). Conclusion The improved laparoscopic excision of tumors through the submucosal tunnel had a significant benefit on the treatment of gastric stromal tumors of ntrinsic source which can reduce the complications and recurrence , thus leading to good application prospects .