腹腔镜联合胃镜治疗胃底部间质瘤32例报告  

The resection of gastric stromal tumors in the gastric fundus with laparoscopy combined with gastroscopy:a report of 32 cases

作　　者：高红雷[1] 孙作成[2] 徐文广[2] 

机构地区：[1]潍坊医学院,山东潍坊261053 [2]潍坊市人民医院

出　　处：《腹腔镜外科杂志》2013年第1期18-20,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜联合胃镜治疗胃底部间质瘤的安全性、可行性及发展前景。方法:回顾分析2009年12月至2012年2月为32例胃底部间质瘤患者行腹腔镜结合胃镜治疗的临床资料,其中25例行胃镜辅助下腹腔镜胃楔形切除术,7例在胃镜辅助下行腹腔镜胃腔内肿瘤切除术。结果:32例手术均获成功,无肿瘤破裂、胃腔狭窄等并发症发生及中转开腹。手术时间平均(81.4±25.7)min,术中出血量平均(38.2±16.1)ml,肠道功能恢复时间平均(34.6±3.8)h,进食时间平均(58.6±10.8)h,术后平均住院(4.6±1.3)d。术后病理切缘均为阴性,术后3个月行胃镜及钡餐造影检查,无胃腔狭窄。术后平均随访(14.8±3.4)个月,X线、B超及CT检查均未发现肿瘤复发及远处转移。结论:胃镜联合超声内镜有助于发现并诊断胃间质瘤,可于术前初步判定危险度。对于胃底部间质瘤,在胃镜辅助定位下行腹腔镜胃部分切除术安全、有效,患者创伤小、预后良好,符合胃肠道间质瘤的治疗原则,降低了贲门狭窄等并发症发生率。Objective：To discuss the security,feasibility and prospect of resection of gastric stromal tumors（GSTs） in the gastric fundus with laparoscopy combined with gastroscopy.Methods：The clinical data of 32 patients with GSTs in the gastric fundus who underwent resection with laparoscopy combined with gastroscopy from Dec.2009 to Feb.2008 were retrospectively analyzed.Twenty-five of them underwent gastroscopy assisted laparoscopic wedge resection of the stomach,and 7 of them underwent gastroscopy assisted laparoscopic endoorgan resection of gastric wall tumors.Results：All the 32 surgeries were accomplished successfully.No complications such as rupture of tumors or stenosis of stomach cavity occurred.No convension to laparotomy occurred.The mean operative time was（81.4± 25.7） min,the mean intraoperative blood loss was（38.2±16.1） ml,recovery time of intestinal tract function was（34.6±3.8） h,the mean time to take food was（58.6±10.8） h and the mean postoperative hospital stay was（4.6±1.3） d.The postoperative pathological margin was negative in all patients,and no stenosis of gastric cavity was found in 3 months after operation by gastroscopy and barium meal.No recurrence or distant metastasis occurred during the following-up of（14.8±3.4） m by X-ray,B-ultrasound and CT scan examination.Conclusions：It is helpful to find and diagnose GSTs and predict the risk before operation by the gastroscopy and endoscopic ultrasonography.For the GSTs in the gastric fundus,laparoscopic gastric partial resection is safe and effective with the location of gastroscopy.This procedure fits to the therapeutic criteria of GSTs and has advantages of minimal invasion,good prognosis and reduction of the rate of cardial stenosis.

关 键 词：胃间质瘤 胃底 腹腔镜检查 胃镜检查 内镜超声 

分 类 号：R735.2[医药卫生—肿瘤]