腹腔镜下胃肠道间质瘤包饺子式切除术50例报告.docVIP

腹腔镜下胃肠道间质瘤“包饺子式”切除术50例报告 张永红 李永翔 安徽医科大学第一附属医院普外科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的 探讨腹腔镜下胃肠道间质瘤 (gastrointestinal stromal tumor, GIST) “包饺子式”切除术的疗效及可行性。方法 2010年7月2015年2月行腹腔镜下GIST“包饺子式”切除术, 采用缝线悬吊后, 直线切割闭合器夹闭, 类似包饺子, 距离肿瘤边缘2 cm以上切除肿瘤。结果 手术时间 (95.8±34.2) min, 术中出血量 (40.2±17.9) ml。50例均完整切除肿瘤, 切缘在2 cm以上, 术后病理切缘未见肿瘤细胞, 病理诊断为GIST, 肿瘤直径5例5 cm, 23例25 cm, 22例2 cm, 无淋巴结转移, 20例极低危, 17例低危, 7例中危, 6例高危。50例术后平均随访24个月 (8-36个月) , 1例术后3个月腹腔大网膜转移, 再次手术切除, 其余49例经胃镜、腹部B超或CT提示无复发和转移。结论 腹腔镜下GIST“包饺子式”切除术可行, 效果良好, 值得进一步推广应用。 关键词： 胃肠道间质瘤; 腹腔镜手术; 作者简介：李永翔, E-mail:yongxiangli_1@ 收稿日期：2016-09-23 Laparoscopic Making-dumplings Resection of Gastrointestinal Stromal Tumor:Report of 50 Cases Zhang Yonghong Li Yongxiang Department of General Surgery, The First Affiliated Hospital of Anhui Medical University; Abstract： Objective To explore the clinical effect and feasibility of laparoscopic making-dumplings resection for gastrointestinal stromal tumor (GIST) . Methods Fifty patients with GIST underwent laparoscopic making-dumplings resection from July 2010 to February 2015. We used suture to overhang the tumor, then sealed the lesion with linear cutting stapler like making-dumplings, finally resected it with a more than 2 cm edge. Results The operation time was (95. 8 ± 34. 2) min and the intraoperative blood loss was (40. 2 ± 17. 9) ml. The tumor body of resected specimen was intact, and the resection margin was more than 2 cm. GIST was diagnosed by pathological examination and immunohistological staining. There were 5 cases of tumor diameter 5 cm, 23 cases between 2 cm and 5 cm, and 22 cases less than 2 cm. No residual tumor or lymph node metastasis was found.According to newly revised NIH risk grading standards, there were 20 cases of very low risk, 17 cases of low risk, 7 cases of moderate risk, and 6 cases of high risk. The mean follow-up time after operation was 24 months (range, 8-36 months) . There was one case of omentum metastas