内镜切除术与腹腔镜切除术治疗非微小胃间质瘤的对比研究

Comparative study of endoscopic resection and laparoscopic surgery in treatment of non microgastric stromal tumors

摘要:

目的 对比分析内镜下切除和腹腔镜手术切除非微小胃间质瘤（直径大于1 cm且小于5 cm）的疗效及安全性。方法 回顾性分析2012年1月－2017年12月在苏州大学附属第一医院和苏州大学附属张家港医院行内镜下切除和外科腹腔镜手术治疗、并经术后病理及免疫组化确诊为非微小胃间质瘤患者的临床资料。根据手术方式将患者分为内镜切除组和腹腔镜手术组，比较两组患者术后住院时间、并发症、治愈性切除率等。结果 内镜切除组术后进食时间、术后排气时间、住院时间较腹腔镜手术组短，住院费用较腹腔镜手术组少，两组患者比较，差异有统计学意义（均P < 0.05）。术后对所有患者进行随访，内镜切除组平均随访时间为32个月，有1例出现复发；腹腔镜手术组平均随访时间为35个月，有1例出现复发，1例出现转移，两组患者比较，差异无统计学意义（P > 0.05）。结论 内镜下切除直径大于1 cm且小于5 cm的非微小胃间质瘤，具有肿瘤切除率高、术后恢复快、并发症少等优势，且与腹腔镜手术相比，复发率无明显差异。

Abstract:

Objective To compare the efficacy and safety of endoscopic resection and laparoscopic resection of non-minimal gastric stromal tumor (more than 1 cm and less than 5 cm).Methods A retrospective analysis was performed on the clinical data of patient with non microgastric stromal tumor patients which confirmed by pathology and immunohistochemistry after endoscopic resection and traditional open surgery from January 2012 to December 2017. The patients were divided into Endoscopy Group and laparotomy group, compared the hospitalization time, complications and curative resection rate etc between the two groups.Results The postoperative eating time, postoperative exhaust time, hospitalization time of endoscopic resection group were significantly shorter than those of laparoscopic surgery group (P < 0.05), and the hospitalization cost of endoscopic resection group was significantly less than that of laparoscopic surgery group (P < 0.05). The average follow-up time of endoscopic groupwas 32 months, and there was 1 case with recurrence. The average follow-up time of laparoscopic group was 35 months, and there was 1 case with recurrence and 1 case with metastasis, there was no significant difference between the two groups (P > 0.05).Conclusion Endoscopic resection has some advantages for non microgastric stromal tumors with diameters more than 1 cm and less than 5 cm. It has high resection rate, less complications and there was no significant difference in recurrence rate between the two groups.