非暴露技术胃部分切除术治疗胃黏膜下层肿瘤的临床可行性分析  

Clinical feasibility of partial gastrectomy using non-exposure technique for the treatment of gastric submucosal tumors

作　　者：段海涛 梁品[1] DUAN Haitao;LIANG Pin(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院胃肠外科,辽宁大连116011

出　　处：《大连医科大学学报》2024年第3期217-220,共4页Journal of Dalian Medical University

摘　　要：目的观察非暴露技术(Clean-net)胃部分切除术治疗胃黏膜下层肿瘤的临床治疗效果及可行性。方法回顾性分析2018年1月至2021年11月大连医科大学附属第一医院胃肠外科收治的术前诊断考虑胃黏膜下层肿瘤17例患者的临床资料,其中男7例,女10例;平均年龄(57.8±11.9)岁。所有患者均行Clean-net胃部分切除手术,在腹腔镜下切开浆肌层,行不损伤黏膜层的肿瘤剥除术,评估其治疗效果。结果17例患者均顺利完成手术,无一例因术中并发症中转开腹,切除瘤体平均直径(4.1±1.8)cm,肿瘤最大直径9.0 cm。术后留置胃管时间(2.5±1.9)d。术后1例患者发热,考虑肺部感染,治疗后缓解。术后恢复流质饮食时间(3.8±2.0)d,术后住院时间(6.5±1.8)d。术后病理间质瘤12例,其中5例低危,4例中危,3例高危。囊肿2例,平滑肌瘤1例,神经鞘瘤1例,胰腺异位1例,所有标本均有完整的包膜。结论Clean-net治疗胃黏膜下层肿瘤短期治疗效果满意,对于保留胃部形态,尤其对于近贲门处肿瘤术后胃功能恢复好,可作为特殊部位(近贲门、近幽门)胃黏膜下肿瘤的保功能手术方式。Objective To study the clinical efficacy and analyze the feasibility of non-exposure technique(Clean-net)partial gastrectomy for the treatment of gastric submucosal tumors.Methods We retrospectively analyzed the clinical data of 17 patients,who were diagnosed preoperatively with gastric submucosal tumors and treated by the same clinical team in the Department of Gastrointestinal Surgery at the First Affiliated Hospital of Dalian Medical University from January 2018 to November 2021.The cohort included 7 males and 10 females with an average age of(57.8±11.9)years.All patients underwent Clean-net partial gastrectomy,which involved laparoscopic incision through the seromuscular layer and tumor debulking without damaging the mucosal layer,and the therapeutic effects were evaluated.Results All 17 patients successfully completed the surgery without any cases of conversion to open surgery due to intraoperative complications.The average size of the resected tumors was(4.1±1.8)cm,with the largest tumor measuring 9.0 cm.The average duration of postoperative indwelling gastric tube was(2.5±1.9)days.One patient experienced postoperative fever,which was considered to be due to lung infection and resolved after treatment.The average time to resume a liquid diet postoperatively was(3.8±2.0)days,and the time of hospitalization was(6.5±1.8)days.Postoperative pathology revealed 12 cases of gastrointestinal stromal tumors(5 low-risk,4 intermediate-risk,and 3 high-risk),2 cases of cysts,1 case of leiomyoma,1 case of schwannoma,and 1 case of ectopic pancreas.All specimens had intact capsules.Conclusion Clean-net treatment of gastric submucosal tumors has a satisfactory short-term therapeutic effect,and the non-exposure technique is good for preserving gastric morphology,especially for postoperative gastric function recovery from tumors in the proximal cardia,and can be used as a function-preserving surgical procedure for gastric submucosal tumors in special regions(proximal cardia,proximal pylorus).

关 键 词：胃部分切除 黏膜下层 非暴露技术 

分 类 号：R656.6[医药卫生—外科学]