Laparoscopic Resection of Gastrointestinal Stromal Tumors: Safe, Efficient, and Comparable Oncologic Outcomes
Laparoscopic Resection of Gastrointestinal Stromal Tumors: Safe, Efficient, and Comparable Oncologic Outcomes
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DOI：
10.1089/lap.2012.0115
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发表时间：
2012-10-01
影响因子：
1.3
通讯作者：
Yeh, Ta-Sen
中科院分区：
文献类型：
--
作者：
Chen, Yu-Hsien;Liu, Keng-Hao;Yeh, Ta-Sen
背景资料：手术胃肠道间质瘤（GISTs）已修改，腹腔镜切除GIST已获得改进和roles.Patients和方法：我们回顾性分析了我们的GIST患者进行腹腔镜手术和传统的开放手术的临床资料和肿瘤学结果。回顾性分析2005年至2010年间于林口长庚医院经病理诊断的227例胃肠道间质瘤病例。我们排除了肿瘤大小>5 cm、单纯活检、联合其他手术、内镜下黏膜切除、肿瘤位于十二指肠、结肠直肠、食管贲门交界处、网膜、盆腔或腹膜后、手术时转移以及GIST免疫组织学检查后诊断为其他疾病的患者。共入组58例患者，其中腹腔镜手术组（LSG）16例，开放手术组（OSG）42例。结果：两组患者在临床人口统计学、肿瘤大小和部位方面无差异。LSG患者恢复饮食的天数更少，术后住院时间更短，患者自控镇痛的使用更少。LSG和OSG的术后并发症发生率分别为6.3%和19%。LSG组的中位随访时间为32.73个月，OSG组为39.75个月。3例（LSG组1例，OSG组2例）出现复发或转移。结论：腹腔镜手术治疗胃、小肠小于5cm的GIST在技术上是可行的。在本研究中，我们证明了LSG患者受益于更少的恢复饮食的天数（5 vs 5.71天），更短的术后住院时间（8 vs 9.07天），以及围手术期更少的患者自控镇痛使用（6.7% vs 90.9%），与OSG患者相比，短期肿瘤学结果相同。
Background: Surgery of gastrointestinal stromal tumors (GISTs) has been modified, and laparoscopic resection of GIST has gained improvement and roles.Patients and Methods: We retrospectively reviewed clinical data and oncological outcomes of our GIST patients who underwent laparoscopic surgery and traditional open surgery. In total, 227 pathologically diagnosed GIST cases were retrospectively reviewed in Chang Gung Memorial Hospital at Linkou, Taipei, Taiwan, between 2005 and 2010. We excluded those with tumor size >5 cm, biopsy-only, combined other operation, endoscopic mucosal resection, tumor located in the duodenum, colon-rectum, esophagocardiac junction, omentum, pelvic area, or retroperitoneum, or metastasis when operated on and those diagnosed as other disease after immunohistologic examination of GIST. Fifty-eight cases were enrolled, including 16 patients in the laparoscopic surgery group (LSG) and 42 patients in the open surgery group (OSG). The patients' demography, perioperative, pathologic result, and oncology result were recorded and analyzed.Results: Both groups showed no difference in clinical demography, tumor size, and locations. LSG patients showed fewer days to resume diet, shorter postoperative hospital stays, and less use of patient-controlled analgesia. The postoperative morbidity in LSG and OSG was 6.3% and 19%, respectively. The median follow-up time was 32.73 months in LSG and 39.75 months in OSG. Recurrence or metastasis was observed in 3 patients (1 in LSG and 2 in OSG). The recurrence rate between LSG and OSG showed no significant difference.Conclusions: Laparoscopic surgery was technically feasible for GIST of no more than 5 cm located at the stomach and small bowel. In the current study, we demonstrated that LSG patients benefited from fewer days to resume diet (5 versus 5.71 days), shorter postoperative stays (8 versus 9.07 days), and less patient-controlled analgesia use (6.7% versus 90.9%) during the perioperative period with the same short-term oncology result compared with OSG patients.