本文關(guān)鍵詞：腹腔鏡與開腹手術(shù)治療胃間質(zhì)瘤的臨床療效對比研究　出處：《山東大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 胃腸間質(zhì)瘤、胃 腹腔鏡 外科手術(shù)

【摘要】：目的：對比研究腹腔鏡手術(shù)與開腹手術(shù)治療原發(fā)性局限性胃間質(zhì)瘤的臨床效果,探討腹腔鏡手術(shù)治療原發(fā)性局限性胃間質(zhì)瘤的可行性。方法：對山東大學(xué)齊魯醫(yī)院普外科2012年4月—2015年4月手術(shù)治療的符合下列入組標(biāo)準(zhǔn)的58例胃間質(zhì)瘤病人的臨床資料進(jìn)行回顧性分析。入組標(biāo)準(zhǔn)：①腫瘤直徑"g1cm或"f10cm；②腫瘤距離幽門或賁門"g3cm(胃鏡和超聲內(nèi)鏡下檢查測定),術(shù)中不需要幽門或賁門切除重建者；③不合并其他臟器切除者；④既往無腹部手術(shù)史者；⑤術(shù)后均經(jīng)病理、免疫組化檢查確診為胃GIST者。58例中,腹腔鏡手術(shù)(簡稱腹腔鏡組)31例,腫瘤最小直徑1cm,最大直徑8.5cm,其中直徑等于或大于5cm者10例,無一例中轉(zhuǎn)開腹。開腹手術(shù)(簡稱開腹組)27例,腫瘤最小直徑lcm,最大直徑8cm,直徑等于或大于5cm者12例。兩組病人在腫瘤所在部位、年齡范圍、性別分布及腫瘤直徑等方面,差異無統(tǒng)計學(xué)意義(表1,P值0.05)。對腹腔鏡組和開腹組總體術(shù)中出血量、手術(shù)時間、術(shù)后住院天數(shù)、術(shù)后肛門排氣時間方面進(jìn)行對比研究。并對比研究不同腫瘤大小和不同部位胃GIST行腹腔鏡手術(shù)及開腹手術(shù)的療效。結(jié)果：腹腔鏡組31例無一例中轉(zhuǎn)開腹。1、不同大小和不同部位的胃GIST患者兩組手術(shù)及術(shù)后情況比較(X±S)見表2。結(jié)果顯示：①胃GIST小于5cm組,腹腔鏡組術(shù)后住院時間明顯短于開腹組(P0.05),而在手術(shù)時間、術(shù)中出血量及術(shù)后排氣時間方面,兩組無明顯差異(P0.05)；②胃GIST等于或大于5cm組,在手術(shù)時間、術(shù)中出血量、術(shù)后排氣時間和術(shù)后住院時間方面,腹腔鏡組與開腹組相當(dāng)(P0.05)；③對胃前壁、胃大彎側(cè)、胃小彎側(cè)GIST患者,腹腔鏡組術(shù)后住院時間明顯短于開腹組(PO.05),而手術(shù)時間、術(shù)中出血量、術(shù)后排氣時間兩組間無顯著差異(P0.05)；④胃后壁GIST患者,腹腔鏡組手術(shù)時間明顯短于開腹組(P0.05),而在、術(shù)中總出血量、術(shù)后肛門排氣時間及術(shù)后住院天數(shù)方面差異不顯著(P值0.05)。2、兩組病人總的手術(shù)及術(shù)后情況比較(X±S)見表3.結(jié)果顯示：腹腔鏡組總的手術(shù)所用時間和術(shù)后住院天數(shù)較開腹組明顯縮短(P值0.05),而術(shù)中出血量、術(shù)后排氣時間和術(shù)后并發(fā)癥發(fā)生率,兩組間無明顯差異(P0.05)結(jié)論：對直徑小于5cm或位于胃前壁及胃大小彎側(cè)的胃GIST,腹腔鏡手術(shù)創(chuàng)傷更小、術(shù)后恢復(fù)時間更短、術(shù)后住院天數(shù)短,較開腹手術(shù)有優(yōu)勢。對直徑等于或大于5cm,等于或小于8.5cm,不影響幽門或責(zé)門的胃GIST患者,只要病例選擇得當(dāng),腹腔鏡手術(shù)的近期效果優(yōu)于開腹手術(shù)。
[Abstract]:Objective: To compare the effects of laparoscopic surgery and open surgery for the treatment of primary clinical effect of localized gastric stromal tumors, laparoscopic surgery for the treatment of primary localized gastric stromal tumor is feasible. Methods: the clinical data of Department of general surgery of Qilu Hospital of Shandong University from April 2012 to April 2015 with surgical treatment of 58 cases of stomach following the standard group stromal tumor patients were retrospectively analyzed. Inclusion criteria: tumor diameter g1cm or f10cm; the tumor from the pylorus or cardiac g3cm (ultrasonic gastroscopy and endoscopic examination determination), pylorus or cardiac resection and reconstruction do not need surgery; when not combined with other organ resection; and no abdominal surgery; the postoperative pathology and immunohistochemical examination confirmed the diagnosis of gastric GIST in.58 cases, laparoscopic surgery (referred to as the laparoscopic group) 31 cases, tumor minimum diameter 1cm, maximum diameter of 8.5cm, the diameter of In 10 cases or more than 5cm, no cases were converted to laparotomy. Open surgery (the laparotomy group) 27 cases, tumor minimum diameter LCM, maximum diameter of 8cm, 12 cases with a diameter equal to or greater than 5cm. Two groups of patients in the tumor location, age range, gender distribution and tumor diameter, no significant difference the significance (Table 1, P = 0.05). The amount of bleeding, total laparoscopic group and laparotomy group in the operation time, postoperative hospital stay, postoperative anal exhaust time were investigated. The effect and comparison of different tumor size and different parts of the stomach GIST laparoscopic surgery and open surgery. Results: the laparoscopic group none of the 31 cases of laparotomy.1, comparison of different sizes and different parts of the stomach GIST of two groups of patients with surgery and postoperative (X + S) see table 2. shows: the stomach GIST less than the 5cm group, the laparoscopic group postoperative hospitalization time was significantly shorter than the laparotomy group (P0.05), and in 鎵嬫湳鏃墮棿,鏈腑鍑鴻閲忓強(qiáng)鏈悗鎺掓皵鏃墮棿鏂歸潰,涓ょ粍鏃犳槑鏄懼樊寮，

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