临床研究(Clinical Research)

腹腔镜胃间质瘤切除的可行性与安全性的肿瘤位置匹配对照研究

Published at: 2016年第25卷第4期

王进 1 , 贾宗良 1 , 樊林 1 , 王海江 1 , 敬亚恒 1 , 车向明 1
1 西安交通大学第一附属医院 普通外科,陕西 西安 710061
通讯作者 向明 车 Email: chexiang@mail.xjtu.edu.cn
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.04.019
基金:
国家自然科学基金资助项目 81472245

摘要

目的:评估腹腔镜手术切除胃间质瘤的可行性及安全性。方法:收集2010年1月—2016年1月期间行胃间质瘤手术切除并符合研究条件的患者资料,将行腹腔镜手术与行开腹手术肿瘤位置相同的患者作1:1匹配,最终腹腔镜组与开腹组各纳入36例,比较两组患者的相关临床指标。结果:两组患者基本资料具有可比性。肿瘤位于近贲门处各5例,胃体小弯侧各12例,胃体(或胃底)各13例,近幽门处各6例。腹腔镜组与开腹组切除方式(楔形切除:26例vs. 23例;胃部分切除:8例vs. 10例)无明显差异(P>0.05)。与开腹组比较,腹腔镜平均手术时间、术中出血量减少(114 min vs. 140 min;90 mL vs. 138 mL);平均肛门排气时间、经口进流食时间、术后住院天数均减少(2.6 d vs. 3.1 d;4.1 d vs. 5.3 d;6.0 d vs. 8.3 d);围手术期总并发症发生率降低(0.0% vs. 16.7%),差异均有统计学意义(均P<0.05)。两组术后病理指标、复发率、总生存率、无病生存率差异均无统计学意义(均P>0.05)。结论:对于原发性胃间质瘤,腹腔镜手术安全有效,且在肿瘤位置相同的条件下,比开腹手术创伤小、并发症少、患者恢复快。


Feasibility and safety of laparoscopic resection for gastric stromal tumor: a tumor location matched case-control study

Abstract

Objective: To evaluate the feasibility and safety of laparoscopic resection for gastric stromal tumors. Methods: The data of patients who underwent surgical resection for gastric stromal tumors and met the study requirements from January 2010 to January 2016 were collected. Patients undergoing laparoscopic and open surgery were matched in a 1:1 ratio according to the tumor location, with 36 cases each in laparoscopic group and open surgery group finally enrolled. The main clinical variables between the two groups of patients were compared. Results: The general data of the two groups of patients were comparable. The tumor in 5 cases was located near the cardia of the stomach, in 12 cases located at the lesser curvature of the stomach and in 13 cases located in the body or fundus of the stomach. The type of gastric resection performed in the laparoscopic and open surgery group (gastric wedge resection: 26 cases vs. 23 cases; gastric partial resection: 8 cases vs. 10 cases) had no statistical difference (P<0.05). In laparoscopic group compared with open surgery group, the average operative time and intraoperative blood loss were reduced (114 min vs. 140 min; 90 mL vs. 138 mL), the average time to flatus and oral liquid food intake as well as length of postoperative hospital stay were shortened (2.6 d vs. 3.1 d; 4.1 d vs. 5.3 d; 6.0 d vs. 8.3 d), and incidence of overall perioperative complications was decreased (0.0% vs. 16.7%), and all differences had statistical significance (all P<0.05). There was no statistical difference in postoperative pathological variables, recurrence rate, and overall survival and disease free survival rate between the two groups (all P>0.05). Conclusion: For primary gastric stromal tumor, laparoscopic surgery is safe and feasible, and compared with open surgery, it has the advantages of less trauma, few complications and quicker recovery of the patients under the condition of same tumor location.


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引用

引用本文: 进 王, 宗良 贾, 林 樊, 海江 王, 亚恒 敬, 向明 车. 腹腔镜胃间质瘤切除的可行性与安全性的肿瘤位置匹配对照研究[J]. 中国普通外科杂志, 2016, 25(4): 581-586.
Cite this article as: WANG Jin, JIA Zongliang, FAN Lin, WAGN Haijiang, JING Yaheng, CHE Xiangming . Feasibility and safety of laparoscopic resection for gastric stromal tumor: a tumor location matched case-control study[J]. Chin J Gen Surg, 2016, 25(4): 581-586.