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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2018年05期

页码:

542-545

栏目:

论著

出版日期:

2018-05-20

文章信息/Info

Title:

Efficacy comparison of laparoscopic surgery and laparotomy for gastrointestinal stromal tumor

作者:

陈诚;  李炜

上海市普陀区中心医院，上海中医药大学附属普陀医院普外科，上海200062

Author(s):

CHEN Cheng;  LI Wei

Shanghai Putuo District Central Hospital, Shanghai 200062, China Corresponding author: CHEN Cheng, E-mail: stt8383@163.com

关键词:

胃肠间质瘤; 腹腔镜; 开腹手术; 并发症; 预后

Keywords:

Gastrointestinal stromal tumor;  Laparoscopy;  Laparotomy;  Complications;  Prognosis

分类号:

R735.2

DOI:

-

摘要:

目的随着腔镜技术的进步，越来越多的胃肠间质瘤（GIST） 患者选择腹腔镜手术治疗，对比分析腹腔 镜与开腹手术治疗GIST 的疗效及预后差异。方法选取2010 年2 月—2016 年6 月上海普陀区中心医院76 例 GIST 患者作为研究对象，随机分为两组，每组38 例，包括行腹腔镜手术治疗（腹腔镜组） 及开腹手术治疗（开 腹组），比较两组患者手术情况、术后并发症发生及预后情况的差异。结果两组患者均顺利完成手术，腹腔镜 组术中出血量、术后腹腔引流量、术后排气时间及术后住院时间均少于开腹组（t 分别为6.910、5.721、5.881、 4.344，P<0.05）。腹腔镜组术后并发症发生率为13.16%，低于开腹组的34.21% （χ2=4.659，P<0.05）。腹腔镜组 术后24h 皮质醇（Cor）、白介素（IL） - 1、肿瘤坏死因子（TNF） -α 均低于开腹组（t 分别为4.442、6.498、 5.129，P<0.05）。腹腔镜组术后复发率为5.84%，开腹组为9.09%，差异无统计学意义（P>0.05），两组均未出 现因GIST 死亡者。结论腹腔镜治疗胃肠间质瘤短期疗效显著，具有创伤小、恢复快、术后并发症少等特 点，远期预后与开腹手术相当。

Abstract:

Objective More and more patients with gastrointestinal stromal tumors （GIST） choose laparoscopic operation with the improvement of laparoscopic technique, and then we compare the clinical efficacy and prognosis of laparoscopic surgery and laparotomy for GIST. Methods A total of 76 patients with GIST hospitalized in Shanghai Putuo District Central Hospital during the period of February 2010 to June 2016 were selected and randomly divided into two groups, with 38 cases in each group. Subjects were treated with laparoscopic surgery （laparoscopic group） or open surgery （laparotomy group） . The operative conditions, postoperative complications and long-term prognosis were compared between the two groups. Results Both groups all successfully complete the operation. The amount of bleeding, postoperative peritoneal drainage doses, postoperative evacuation time and postoperative hospital stays in laparoscopic group were less than those in laparotomy group （t=6.910, 5.721, 5.881, 4.344, P<0.05） . The incidence of postoperative complications in laparoscopic group was less than that in laparotomy group （13.16% vs. 34.21%; χ2=4.659, P<0.05） . The 24 h cortisol, interleukin-1, and tumor necrosis factor- α were lower in the laparoscopic group than in laparotomy group （t=4.442, 6.498, 5.129, all P<0.05） . There was no significant difference in recurrence rate between the two groups （5.9% vs. 9.1%, P>0.05）. Conclusions Laparoscopic surgery has obviously short-term curativeeffect, smaller trauma, faster recovery and less postoperative complications in the patients with gastrointestinal stromal tumors compared to laparotomy, but has the comparable long-term prognosis.

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备注/Memo

备注/Memo:

作者简介：陈诚，大学本科，主治医师，研究方向：普外科 通信作者：陈诚，E-mail: stt8383@163.com

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更新日期/Last Update: 2018-05-28