Clinical analysis of combined laparoscope-gastroscopy for the treatment of difficult gastric stromal tumors

doi:10.3877/cma.j.issn.1674-3946.2023.03.014

Abstract

Abstract:

Objective

To investigate the safety and efficacy of combined laparoscopic gastroscopy（LECS）in the treatment of difficult gastric stromal tumors（GST）.

Methods

Sixty cases of GST at difficult sites that received radical surgery from January 2013 to January 2023 were retrospectively included. The patients were divided into two groups according to the operation methods：double-lens group（28 cases）and laparotomy group（32 cases）. SPSS 20.0 software was used for statistical analysis. Perioperative indicators and other measurement data were expressed by（

x ˉ

±s），and independent sample t test was performed. The statistical data of postoperative complications were χ² or Fisher test. P<0.05 was considered statistically significant.

Results

Compared with the laparotomy group，patients in the double-lens group had less blood loss and faster postoperative recovery time. There were no significant differences in operative time，positive margin，postoperative complications and postoperative exhaust time（P>0.05）.

Conclusion

LECS is a precise，minimally invasive，safe and reliable method for GST treatment of difficult sites. It has the advantages of less bleeding and faster postoperative recovery，and can achieve the radical effect of tumor treatment equivalent to open surgery，which has great potential for clinical promotion.

Key words: Gastric Stromal Tumors, Laparoscopic and Endoscopic Cooperative Surgery, Safety, Comparative Effectiveness Research

Jie Zhang, Yuan Lyu, Liang Sun, Hui Su, Hui Xie, Qiang Yuan, Xin Wang, Junfeng Du, Peng Jin, Gang Chen. Clinical analysis of combined laparoscope-gastroscopy for the treatment of difficult gastric stromal tumors[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(03): 284-286.

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References 12

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组别	例	年龄 (岁)	性别	肿瘤直径(cm)	肿瘤部位
组别	例	年龄 (岁)	男/女	肿瘤直径(cm)	胃窦/贲门/小弯+后壁
双镜组	28	60.1±4.6	16/12	3.8±1.2	4/11/13
开腹组	32	61.7±3.3	15/17	3.4±1.0	6/10/16
t/χ²值		1.52	0.63^a	1.47	0.49^a
P值		0.14	0.43	0.15	0.78

组别	例	年龄 (岁)	性别	肿瘤直径(cm)	肿瘤部位
组别	例	年龄 (岁)	男/女	肿瘤直径(cm)	胃窦/贲门/小弯+后壁
双镜组	28	60.1±4.6	16/12	3.8±1.2	4/11/13
开腹组	32	61.7±3.3	15/17	3.4±1.0	6/10/16
t/χ²值		1.52	0.63^a	1.47	0.49^a
P值		0.14	0.43	0.15	0.78

组别	例	NIH病理危险度分级
组别	例	极低度危险	低度危险	中度危险	高度危险
双镜组	28	9(32.1)	11(39.3)	7(25.0)	1(3.6)
开腹组	32	10(31.3)	14(43.8)	6(18.8)	2(6.3)
z值		-0.63
P值		0.95

组别	例	NIH病理危险度分级
组别	例	极低度危险	低度危险	中度危险	高度危险
双镜组	28	9(32.1)	11(39.3)	7(25.0)	1(3.6)
开腹组	32	10(31.3)	14(43.8)	6(18.8)	2(6.3)
z值		-0.63
P值		0.95

分组	例	手术时间(min)	术中出血量(ml)	切缘阳性
双镜组	28	183.0±22.0	25.0±6.5	0
开腹组	32	179.4±19.3	57.2±15.2	0
t值		0.68	10.87	-
P值		0.50	0.00	-

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