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目的:探讨3D腹腔镜手术治疗胃底部间质瘤的临床应用价值。方法:回顾性分析武汉大学人民医院2014年1月—2015年6月间收治的36例胃底部间质瘤患者临床资料,其中18例行3D腹腔镜手术(3D腔镜组),18例行开腹手术(开放手术组),比较两组患者的围手术期指标,术后病理资料及复发转移情况。结果:两组患者在年龄、性别、BMI、肿瘤大小等一般资料方面差异无统计学意义(均P>0.05)。两组手术时间差异无统计学意义(P>0.05),但3D腔镜组在术中出血量、手术切口长度、术后排气时间及住院天数等指标方面均明显优于开放手术组(均P<0.05)。两组患者均未出现肿瘤破裂以及切缘阳性的情况,均未发生大出血、吻合口瘘、术后肠梗阻等严重并发症,术后病理及免疫组化特征均无明显差异(均P>0.05)。所有患者随访12~36个月,无复发、转移及死亡病例。结论:应用3D腹腔镜技术治疗胃底部间质瘤,能明显减少患者的手术创伤,且远期疗效与开放手术相似。
Objective: To investigate the clinical value of 3D laparoscopic surgery for gastric stromal tumors. Methods: The clinical data of 36 patients with gastric stromal tumors treated by the People’s Hospital of Wuhan University from January 2014 to June 2015 were retrospectively analyzed. Among them, 18 cases underwent 3D laparoscopic surgery (3D endoscopy) and 18 cases The patients underwent open surgery (open surgery group). The perioperative indexes, postoperative pathological data and recurrence and metastasis were compared between the two groups. Results: There was no significant difference in general information such as age, sex, BMI, tumor size between the two groups (all P> 0.05). There was no significant difference in operative time between the two groups (P> 0.05). However, the 3D endoscopy group was significantly better than the open surgery group in terms of intraoperative blood loss, length of incision, postoperative exhaust time and days of hospitalization P <0.05). There was no tumor rupture and positive margins in both groups, and no serious complications such as hemorrhage, anastomotic fistula, or postoperative intestinal obstruction occurred. There was no significant difference in pathological features and immunohistochemical characteristics between the two groups (all P> 0.05 ). All patients were followed up for 12 to 36 months without recurrence, metastasis and death. Conclusion: The application of 3D laparoscopy in the treatment of gastric stromal tumors can significantly reduce the surgical trauma of patients, and the long-term curative effect is similar to that of open surgery.