摘要
Abstract
Objective:To compare the clinical effect of total laparoscopic and open surgery for gastric stromal tumors≤5 cm in diameter and explore the application prospect of the laparoscopic surgery. Methods:Fifty-nine patients who underwent wedge resection of gastric stromal tumors in Department of General Surgery,the General Hospital of PLA from January 1,2010 to January 1,2015 were identified. Twenty-two of them were treated by laparoscopic resection,and the rest of the cases underwent laparotomy. The perioperative condition and prognosis for each surgical type were compared retrospectively. Results:There was no significant difference in gender composition,age,tumor site and maximum diameter between the two groups. Laparoscopic wedge resection was superior to laparotomy treatment in operation time [(53. 95±19. 59) min vs. (103. 84±21. 257) min,t=-8. 969,P<0. 001],blood loss [39. 41 (2-100) ml vs. 121. 35 (20-400) ml,Z=-4. 285,P<0. 001],time to first flatus [1. 91 (1-3) d vs. 3. 72 (2-5) d,Z=-4. 871,P<0. 001],time to liquid diet [2. 73 (2-4) d vs. 4. 38 (3-6) d,Z=-5. 319,P<0. 001],postoperative hospital stay [4. 55 (3-6) d vs. 7. 70 (5-10) d,Z=-6. 166,P<0. 001],change level of CRP [(3. 13±0. 97) mg/dl vs. (5. 48±1. 98) mg/dl,t=-6. 10,P<0. 001],IL-6 [(8. 69±2. 52) ng/L vs. (14. 87±3. 81) ng/L,t=-6. 77,P<0. 001] after 4 h of postoperation and pain score (3. 64±0. 902 vs. 5. 43±1. 068,t=-6. 604,P<0. 001). During the short-term follow-up of 6-36 months,no recurrence or distant metastasis were found. Conclusions:Com-pared with laparotomy treatment,total laparoscopic wedge resection for gastric stromal tumors ≤5 cm in diameter permits minimized surgical trauma,reduced pain and shorter recovery time,meanwhile the postoperative recurrence and metastasis rates do not increase. According to our comparison,total laparoscopic wedge resection for gastric stromal tumors may have a good application prospect in fu-ture.关键词
胃肠道间质肿瘤/腹腔镜检查/剖腹术/疗效比较研究Key words
Gastrointestinal stromal tumors/Laparoscopy/Laparotomy/Comparative effectiveness research分类
医药卫生
