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目的探讨术中胃镜定位联合腹腔镜治疗微小胃间质瘤的临床价值。方法选择患者80例,随机分为两组,每组各40例。对照组术中根据术前所行超声、CT、胃镜等检查结果行腹腔镜下胃部分切除术;观察组则实施术中胃镜下定位结合腹腔镜下胃部分切除或肿瘤切除术,比较两组患者术中情况及术后感染、肿瘤完全切除情况及术后吻合口愈合情况。结果观察组、对照组手术时间分别为(39.6±2.8)、(49.5±3.8)min,差异有统计学意义(t=13.265,P<0.01);术中出血量分别为(15.0±1.8)、(56.3±5.6)ml,差异有统计学意义(t=44.406,P<0.01)。观察组与对照组术后发生感染分别为2、3例,差异无统计学意义(χ2=0.000,P>0.05);术后复查发现肿瘤未完全切除者分别1、8例,差异有统计学意义(χ2=4.507,P<0.05);术后发生吻合口漏分别为1、9例,差异有统计学意义(χ2=5.600,P<0.05);术后肛门排气时间分别为(48.6±11.2)h、(65.3±21.0)h,差异有统计学意义(t=4.478,P<0.01)。结论胃镜联合腹腔镜治疗微小胃间质瘤效果确切,完全切除率高,术后恢复快。
Objective To investigate the clinical value of intraoperative gastroscope positioning combined with laparoscopy in the treatment of gastric cancer. Methods Eighty patients were selected and randomly divided into two groups, 40 cases in each group. The patients in the control group underwent laparoscopic partial gastrectomy according to the results of preoperative ultrasound, CT and gastroscopy. The patients in the observation group underwent gastroscopic positioning combined with laparoscopic partial gastrectomy or tumor resection. Patient’s intraoperative and postoperative infection, tumor resection and anastomotic healing. Results The operation time of the observation group and the control group were (39.6 ± 2.8) and (49.5 ± 3.8) min, respectively, with significant difference (t = 13.265, P <0.01) (56.3 ± 5.6) ml, the difference was statistically significant (t = 44.406, P <0.01). In the observation group and the control group, there were 2 and 3 cases of postoperative infection, respectively, with no significant difference (χ2 = 0.000, P> 0.05). The postoperative findings showed that the tumor was not completely resected in 8 cases (Χ2 = 4.507, P <0.05). There were 1,9 cases of anastomotic leakage after operation, the difference was statistically significant (χ2 = 5.600, P <0.05) 11.2) h, (65.3 ± 21.0) h, the difference was statistically significant (t = 4.478, P <0.01). Conclusion Gastroscopy combined with laparoscopy for the treatment of gastric cancer has the exact effect, complete resection rate, fast recovery.