内镜下微创治疗及外科手术治疗不同肿瘤直径的胃间质瘤的疗效分析  

Analysis on the efficacy of endoscopic resection and surgical treatment for gastric stromal tumors with different tumor diameters

作　　者：马文慧 卢桂芳[1] 杜静 郭梦 任牡丹[1] 殷燕[1] 卢新兰[1] 和水祥[1] MA Wen-hui;LUGui-fang;DU Jing;GUO Meng;REN Mu-dan;YIN Yan;LU Xin-lan;HE Shui-xiang(Department of Gastroenterology,the First Affiliated Hospital of Xi'an Jiaotong University,710061 Xi'an,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院消化内科,陕西西安710061

出　　处：《临床消化病杂志》2023年第5期339-343,共5页Chinese Journal of Clinical Gastroenterology

基　　金：陕西省重点产业创新链-上消化道肿瘤早防早诊早治关键技术(No:S2021-YF-ZDCXL-ZDLSF-0181)。

摘　　要：[目的]通过对比内镜下微创治疗及外科手术治疗不同直径的胃间质瘤的手术成功率、时间经济成本以及并发症等,分析内镜下切除不同直径的胃间质瘤的有效性及安全性。[方法]收集经病理证实为胃间质瘤且无远处转移的87例患者的临床资料,根据切除方式不同分为内镜组和手术组,每组根据肿瘤直径不同分为r<2 cm亚组及2 cm≤r≤5 cm亚组。对2组患者的临床特征进行分析,并比较2组在不同肿瘤直径下的手术成功率、手术后的住院时长、住院费用、手术持续时间、术中及术后并发症的严重性及发生率等。[结果]在肿瘤直径r<2 cm的患者中,内镜组及手术组的胃间质瘤均成功切除且无术中及术后并发症的发生;在肿瘤直径2 cm≤r≤5 cm的患者中,内镜组有1例因为术中出血较多转外科手术治疗,内镜组的手术成功率为94.12%;手术组的手术成功率为100%,但有1例外科手术后因为吻合口发生了瘘再次行手术进行修补;2组的手术成功率和术中及术后并发症的发生率比较差异无统计学意义(P>0.05)。内镜组的手术时间、住院时间及住院费用均小于手术组,2组比较差异有统计学意义(P<0.05)。[结论]对于肿瘤直径r≤5 cm且无远处转移的胃间质瘤,内镜下切除能取得较好的临床效果,具有微创、有效、经济等优势,但是对于病变较大或者浸润较深的胃间质瘤,内镜下切除操作难度大,术前需要严格把握适应证,完善术前超声内镜及腹部CT检查,准确评估胃间质瘤的肿瘤直径及浸润深度,必要时可于手术室完成内镜下治疗。[Objective]To analyze the efficacy and safety of endoscopic resection and surgical resection on gastric stromal tumors with different tumor diameters.[Methods]Data of 87 patients accepted endoscopic resection and surgical resection in the First Affiliated Hospital of Xi'an Jiaotong University from January 2014 to December 2020 were collected.They were divided into endoscopic treatment group and surgical operation group according to the treatment method.They were also divided into two subgroups according to tumor diameter,r<2 cm and 2 cm≤r≤5 cm.The clinical characteristics of the 2 groups were analyzed,and the success rate of surgery,length of hospital stay,cost of hospital stay,duration of surgery,and incidence of intraoperative and postoperative complications were compared between the 2 groups under different tumor diameters.[Results]Tumor resection was successful in both the endoscopic group and the surgical group with tumor diameter r<2 cm,without intraoperative and postoperative complications.The operative time,postoperative hospital stay and hospitalization cost in the endoscopic group were all lower than those in the surgical group,the difference between the two groups was statistically significant(P<0.05).Patients with tumor diameter of 2 cm≤r≤5 cm,in the endoscopic group,1 patient had more intraoperative bleeding and was transferred to surgery,the success rate of the endoscopic treatment group was 94.12%.The success rate of the surgical operation group was 100%,but 1 patient underwent a second surgical repair after surgery because of anastomotic fistula.There was no significant difference in the success rate and the occurrence of intraoperative and postoperative complications between the endoscopic group and the surgical group(P>0.05).The operative time,postoperative hospitalization time and hospitalization cost of the endoscopic group were all lower than those of the surgical group,the difference between the two groups was statistically significant(P<0.05).[Conclusion]Endoscopic treatment of gast

关 键 词：胃固有层间质瘤 内镜黏膜下挖除术 外科手术 

分 类 号：R730.262[医药卫生—肿瘤]