微创外科手术治疗胃间质瘤的回顾性研究  

Management of gastric gist with mimally invasive surgery, a retrospective study

作　　者：宋延冰 张庆钊[2] 张小桥[2] 姚西宝 吉棚[2] 杨坤[2] 杨同辉[2] SONG Yan-bing;ZHANG Qing-zhao;ZHANG Xiao-qiao;YAO Xi-bao;JI Peng;YANG Kun;YANG Tong-hui(Department of General Surgery,People’s Hospital of Pingyuan County,Pingyuan,Shandong,253100;Department of General Surgery,General Hospital of Jinan Military Area,People’s Liberation Army of China,Jinan,Shandong,250031)

机构地区：[1]平原县第一人民医院普外科,山东平原253100 [2]济南军区总医院普外科,山东济南250031

出　　处：《临床普外科电子杂志》2017年第3期5-9,共5页Journal of General Surgery for Clinicians(Electronic Version)

基　　金：第54批中国博士后科学基金面上项目(2013M542475)

摘　　要：目的探讨腹腔镜和达芬奇手术机器人微创治疗胃间质瘤的安全性和有效性。方法回顾性分析2009年1月至2017年6月期间接受腹腔镜或达芬奇手术机器人胃局部或楔形切除术的28例胃间质瘤患者的临床资料,统计分析肿瘤大小、危险度分级、手术时间、出血量、术后并发症和随访结果等指标。结果 28例手术均应用腹腔镜或者达芬奇手术机器人完成,没有中转开腹或中转腹腔镜手术的病例,其中25例腹腔镜手术,3例达芬奇机器人手术,手术方式均为胃局部切除或者楔形切除,平均手术时间(147±65)分钟(65~315分钟)、术中出血量平均为(15.9±11.1)ml(5~50ml)、切口平均长度为(5.3±1.6)cm(3~8cm)。28例患者术后恢复顺利,除1例患者并发切口表浅感染外没有其他并发症。肿瘤最大径平均为(4.6±1.9)cm(1.5~9.0cm)。所有标本肉眼及镜下切缘均阴性,危险度分级:极低危、低危及中危组分别为10、12、6例,没有高危患者。平均随访时间为44.1个月(0.5~84)个月,全组患者没有发现复发转移及死亡病例。结论腹腔镜和达芬奇手术机器人实施胃局部或者楔形切除术治疗胃间质瘤是一种安全、有效的治疗方法。Objective To evaluate the feasibility and safety of robot assisted surgery and laparoscopic surgery for gastric stromal tumors(GIST).Methods Twenty-eight patients with gastric GIST were treated with laparoscopic or robotic local resection or wedge resection from January,2009 to June,2017.The medical records were reviewed retrospectively,the durations of operation,estimated intraoperative blood loss,the location,diameter and risk grade of tumo were calculated.The occurrence of complications were retrievaled.All the patients were followed up.Results All the 28 patients were treated with robotic or laparoscopic local or wedge resection,without conversion to open or laparoscopic surgery.The average duration of operation was(147±65)min(65~315min).The average estimated blood loss was(15.9±11.1)ml(5~50ml).The average length of incision was(5.3±1.6)cm(3~8cm).The recovery process of all patients went well surgical site infections occurred in one patient.All the patients achieved R0 resection.The average diameter was(4.6±1.9)cm(1.5~9.0cm).On follow up for 0.5 to 84 months,neither recurrence nor metastasis was detected.Conclusions Robot assisted or laparoscopic local or wedge resection was feasible and effective for the surgical management of patients with gastric GIST.

关 键 词：胃肠道间质瘤 胃楔形切除术 腹腔镜 机器人 

分 类 号：R735.2[医药卫生—肿瘤]