球囊胃管引导3D腹腔镜楔形切除术治疗邻近贲门部胃间质瘤  

Efficacy analysis of 3D laparoscopic wedge resection guided by calibratingbougie for gastric gastrointestinal stromal tumors adjacent to the cardia

作　　者：王琦[1] 孙华文[1] 王秋爽[1] 杨厚涞 沈世强[2] Wang Qi;Sun Huawen;Wang Qiushuang;Yang Houlai;Shen Shiqiang(The First Department of Gastrointestinal Surgery, Renrnin Hospital of Wuhan University, Wuhan 430060, Chin)

机构地区：[1]武汉大学人民医院胃肠外一科,武汉430060 [2]武汉大学人民医院普通外科,武汉430060

出　　处：《腹部外科》2018年第2期112-115,共4页Journal of Abdominal Surgery

基　　金：湖北省自然科学基金(2017CFB781)

摘　　要：目的探讨应用球囊胃管引导3D腹腔镜楔形切除术治疗邻近贲门部胃间质瘤的安全性和可行性。方法 2014年1月至2015年12月间,对武汉大学人民医院就诊的20例邻近贲门部(距离≤5 cm)胃间质瘤病人,在球囊胃管引导下行3D腹腔镜楔形切除术。回顾性分析该组病人的围手术期指标,术后病理结果及复发转移情况。结果所有病人均在球囊胃管引导下完成3D腹腔镜楔形切除术,未发生术中肿瘤破裂、中转开腹以及术后病理切缘阳性。平均手术时间(79.2±23.4)min,术中平均出血量(35.1±17.1)ml。除1例术后腹腔出血病人经保守治疗痊愈外,无其他术后并发症发生。术后3个月胃镜或上消化道钡餐检查未发现贲门狭窄。随访12~38个月(中位随访时间为22.5个月)未见肿瘤复发和转移。结论对于邻近贲门的胃间质瘤,应用球囊胃管引导行3D腹腔镜楔形切除术安全可行,符合手术原则,并可预防术后贲门狭窄。Objective To evaluate the safety and feasibility of 3D laparoscopic wedge resection（LWR）guided by calibrating bougie for gastric gastrointestinal stromal tumors（GIST）adjacent to the cardia.Methods From January 2014 to December 2015,we performed 3D LWR guided by calibrating bougie on 20 cases of gastric GIST near to（≤5 cm）the cardia.Perioperative records,histopathology results and long-term outcomes of these patients were retrospectively analyzed.Results In all patients given3 D LWR guided by calibrating bougie,there was no tumor rupture,conversion to open access or residual neoplasms of resection margin.The mean procedure duration was 79.2±23.4 min and the mean blood loss was 35.1±17.1 mL.No more complications occurred except 1 case of postoperative abdominal bleeding cured by conservative therapy.No cardia stenosis was seen under the gastroscopy and angiography of the upper gastrointestinal tract 3 months after the operation.All 20 cases were followed up for 12 to 38 months（mean：22.5 months）,and none of them had tumor recurrence or metastasis.Conclusions 3D LWR guided by calibrating bougie is safe and feasible for gastric GIST adjacent to the cardia.This procedure fits to the therapeutic criteria of GIST and effectively prevents the cardia stenosis.

关 键 词：胃肠道间质瘤 贲门 球囊胃管 腹腔镜 三维视觉 

分 类 号：R735.2[医药卫生—肿瘤]