腹腔镜手术与开腹手术行食管胃结合部胃肠间质瘤切除的疗效比较  

Efficacy comparison of laparoscopy and open resection for gastrointestinal stromal tumor at the ;esophagogastric junction

作　　者：王超[1] 高志冬[1] 申占龙[1] 梁斌[1] 姜可伟[1] 沈凯[1] 谢启伟[1] 王杉[1] 叶颖江[1] 

机构地区：[1]北京大学人民医院胃肠外科,100044

出　　处：《中华胃肠外科杂志》2015年第9期881-884,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：高等学校博士学科点专项新教师科研基金（20130001120064）

摘　　要：目的：比较腹腔镜手术与开腹手术行食管胃结合部胃肠间质瘤切除的临床疗效差异。方法回顾性分析北京大学人民医院胃肠外科2004年10月至2014年10月间接受手术治疗的42例食管胃结合部胃肠间质瘤患者的临床病理资料。其中开腹手术20例（开腹组），腹腔镜手术22例（腹腔镜组），比较两组患者的短期疗效和长期预后。结果两组患者临床资料一致性良好。在短期疗效方面，腹腔镜组术后排气时间、术后恢复活动时间、术后进食时间和术后住院时间均明显少于开腹组（P＜0．05）；手术相关并发症发生率腹腔镜组与开腹组差异无统计学意义（0比10％，P＝0．221）。在远期疗效方面，腹腔镜组与开腹组5年无病生存率差异无统计学意义（100％比89％，P＝0．384）。结论腹腔镜手术治疗食管胃结合部胃肠间质瘤的短期疗效优于开腹手术，长期预后与开腹手术相当。Objective To compare the clinical outcomes between laparoscopy and open resection for gastrointestinal stromal tumor at the esophagogastric junction. Methods Clinicopathological data of 42 patients with gastrointestinal stromal tumor （GIST） of esophagogastric junction undergoing resection in our department between October 2004 and October 2014 were retrospectively analyzed. Among them, 22 patients underwent laparoscopic resection （LR group） and 20 patients underwent open resection （OR group）. Short-term efficacy and long-term outcomes were compared between the two groups. Results There were no significant differences between the two groups in common data of patients. The recovery time in the LR group was significantly shorter than that in the OR group , including bowel function recovery, ambulation, resumption of oral intake, and postoperative hospital stay （all P＆lt;0.05）. The incidence of postoperative complications in the LR group was lower than that in the OR group （0 vs. 10%, P=0.221）. Meanwhile difference of 5-year disease-free-survival between the two groups （LR 100% vs. OR 89% , P =0.384） was not statistically significant. Conclusion Laparoscopic resection for gastrointestinal stromal tumor at the esophagogastric junction is superior to open resection in short-term efficacy, and similar to open resection in long-term outcomes.

关 键 词：胃肠间质瘤 食管胃结合部 腹腔镜手术 开腹手术 疗效 

分 类 号：R735[医药卫生—肿瘤]