Laparoscopic vs open resection of gastric stromal tumors
Laparoscopic vs open resection of gastric stromal tumors
复制标题
DOI：
10.1007/s00464-001-8319-z
复制
发表时间：
2002-05-01
影响因子：
3.1
通讯作者：
Heniford, BT
中科院分区：
文献类型：
--
作者：
Matthews, BD;Walsh, RM;Heniford, BT
背景：胃间质瘤是罕见的肿瘤，可能是良性的，也可能是恶性的。鉴于恶性胃间质瘤很少累及淋巴结并且需要切缘阴性的切除，因此它们似乎可以通过腹腔镜切除术进行治疗。腹腔镜切除术的报道很少，也没有对腹腔镜和开腹手术进行比较。本研究比较了两种方法的相对疗效。方法：1994年5月至2000年12月期间，33名患者因胃间质瘤接受了35次手术。 21 名患者接受了腹腔镜切除术； 12 名患者接受了开放性切除术。回顾性审查患者的医疗记录，包括手术时间、失血量、住院时间和临床病程。结果：两组患者的人口统计学、肿瘤特征（平均肿瘤大小、良性与恶性）和表现症状相似。腹腔镜组楔形切除15例；进行了 3 次部分胃切除术和 3 次经胃针镜剜除术。在开放组中，进行了六次边缘切除术、四次胃切除术和两次部分近端胃切除术。腹腔镜组和开腹组的平均手术时间（169 分钟 vs 160 分钟）、平均估计失血量（106 vs 129 cc）或围手术期并发症发生率（9.5% vs 8.3%）均无显着差异。腹腔镜组的平均住院时间明显较短 (p < 0.05)（3.8 天 vs 6.2 天）。平均随访时间为 1.5 年。每组中有一名患者因转移性疾病死亡。目前尚未出现套管针部位复发的情况。结论：腹腔镜胃间质瘤切除术是安全、适宜的。肿瘤大小、手术时间和估计失血量与开腹手术相当，并且腹腔镜组的住院时间在统计学上更短。
Background: Gastric stromal tumors are rare neoplasms that may be benign or malignant. Given that malignant gastric stromal tumors rarely involve lymph nodes and require excision with negative margins, they appear amendable to laparoscopic excision. There are few reports of laparoscopic resection, and no comparisons have been done between laparoscopic and open surgery. This study compares the relative efficacy of the two approaches.Methods: Between May 1994 and December 2000, 33 patients underwent 35 operations for gastric stromal tumors. Laparoscopic resections were performed in 21 patients; open resections were done in 12 patients. The medical records of the patients were reviewed retrospectively with regard to operating time, blood loss, length of stay, and clinical course.Results: Patient demographics, tumor characteristics (mean tumor size, benign vs malignant), and presenting symptoms were similar for both groups. In the laparoscopic group, 15 wedge resections; three partial gastrectomies, and three transgastric needlescopic enucleations were performed. In the open group, six vedge resections, four antrectomies, and two partial proximal gastrectomies were performed. There were no significant differences in mean operative time (169 vs 160 min), mean estimated blood loss (106 vs 129 cc), or perioperative complication rate (9.5% vs 8.3%) between the laparoscopic and open groups, respectively. The mean length of stay was significantly less (p < 0.05) in the laparoscopic group (3.8 vs 6.2 days). Average follow-up was 1.5 years. One patient in each group has died due to metastastic disease. There have been no trocar site recurrences.Conclusions: Laparoscopic resection of gastric stromal tumors is safe and appropriate. Tumor size, operating time, and estimated blood loss were equivalent to the open approach, and there was a statistically shorter hospital stay in the laparoscopic group.