腹腔镜手术治疗直径大于5cm的胃肠间质瘤患者的疗效分析  

Analysis on curative effect of laparoscopic surgery in treatment of patients with gastric gastrointestinal stromal tumors with tumor diameter more than 5cm

作　　者：庄金福[1] 叶建新[1] 黄永建[1] ZHUANG Jinfu YE Jianxin HUANG Yongjian(Department of Gastrointestinal Surgery, First Affiliated Hospital, Fujian Medical University, Fuzhou 350004, Chin)

机构地区：[1]福建医科大学附属第一医院胃肠外科,福建福州350004

出　　处：《吉林大学学报（医学版）》2017年第3期626-629,共4页Journal of Jilin University：Medicine Edition

基　　金：卫生部医药卫生科技发展研究项目资助课题(W2013FZ08)

摘　　要：目的:探讨腹腔镜手术切除直径大于5cm的胃肠间质瘤(GIST)的可行性和中短期疗效。方法:回顾性分析26例接受腹腔镜手术治疗的直径大于5cm的胃GIST患者的临床资料,观察患者术后恢复情况、并发症和中短期预后。结果:26例患者均行腹腔镜手术切除,无1例中转开腹。根据肿瘤部位和生长方式行腹腔镜全胃切除1例,腹腔镜近端胃切除2例,腹腔镜远端胃切除3例,其余20例均行腹腔镜下胃局部切除术。26例患者肿瘤平均直径为(5.94±1.28)cm,平均手术时间为(84.23±27.02)min,术中平均出血量为(72.38±34.24)mL。术后胃肠功能平均恢复时间为(2.77±0.65)d,术后平均住院时间为(7.04±2.24)d。术后腹腔内出血1例,吻合口狭窄1例,均经保守治疗后好转。术后病理(按照改良NIH标准),中危患者18例(69.23%),高危患者8例(30.77%)。术后口服格列卫辅助治疗12例。术后肝脏多发转移1例,其余患者未见局部复发及远处转移。结论:直径大于5cm的胃GIST患者行腹腔镜切除的中短期疗效确切且安全可行。Objective：To investigate the feasibility,moderate-and short-term efficacies of laparoscopic surgery in the resection of the gastric gastrointestinal stromal tumors（GIST）with the tumor diameter more than 5 cm.Methods：The clinicopathological data of 26 gastric GIST patients with the diameter more than 5 cm underwent laparoscopic complete resection were retrospectively analyzed.The postoperative recovery,complications and moderate-and short-term prognosis of the patients were observed.Results：All the patients underwent laparoscopic surgery resection without open operation.According to the location and growth types of tumors,the total gastrectomy was performed in 1 case,the approximal gastrectomy was performed in 2 cases,the distal gastrectomy was performed in 2 cases,and the gastric local resection was performed in the rest 20 cases.The mean diameter of tumors was （5.94±1.28） cm,the mean operational time was （84.23±27.02） min,and the mean blood loss was （72.38±34.24） mL.The postoperative recovery time of bowel function was （2.77±0.65）d and the mean length of postoperative hospitalization time was （7.04±2.24） d.There was 1 case of intraperitoneal hemorrhage and 1 case of anastomotic stenosis;they recovered after conservative therapy.The postoperative pathology results（according to the modified NIH standard） indicated the number of moderate-risk patients was 18（69.23%）,and the number of high-risk patients was 8（30.77%）.A total of 12 cases accepted the adjuvant therapy with imatinib.There was 1 case of hepatic multimetastasis,and there was no local recurrence or death in the other patients.Conclusion：The moderate-and short-term efficacies of laparoscopic surgery in the gastric GIST patients with the tumor diameter more than 5 cm is safe and feasible.

关 键 词：胃肠间质肿瘤 腹腔镜手术 微创手术 

分 类 号：R735.2[医药卫生—肿瘤]