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目的探讨腹腔镜下胃部分切除治疗胃间质瘤的可行性及临床应用价值。方法回顾分析施行腹腔镜下胃部分切除治疗胃间质瘤22例的临床资料。结果肿瘤位于小弯侧13例,大弯侧9例;直径1.5～3 cm。22例手术均顺利完成,术中快速冷冻切片提示胃梭形细胞瘤,术后病理切缘均阴性,手术时间40～110 min(平均55 min),术中出血量50～150 mL(平均80 mL),术后24～48 h肠道功能恢复,术后住院3～7 d,无1例发生并发症。术后随访1～17个月,胃镜复诊未发现复发及转移。结论腹腔镜下胃部分切除治疗肿瘤为1.5～3 cm的胃间质瘤是安全、可行、有效的。胃腔外切除有胃内容物不外溢,污染少等优点,可不放置腹腔引流管,值得临床推广。
Objective To investigate the feasibility and clinical value of laparoscopic partial gastrectomy for gastric stromal tumors. Methods The clinical data of 22 cases of gastric stromal tumor treated by laparoscopic partial gastrectomy were retrospectively analyzed. Results The tumor was located on the lesser curvature side in 13 cases and on the greater curvature side in 9 cases. The diameter was 1.5 ~ 3 cm. All of the 22 cases were successfully performed. Intraoperative fast frozen sections showed that the spindle cell tumor of the stomach was negative. The pathologic margins were all negative after operation. The operation time was 40 to 110 minutes (mean 55 minutes) and the intraoperative blood loss was 50 to 150 ml (average 80 mL). The intestinal function recovered 24 to 48 hours after operation and was hospitalized for 3 to 7 days after operation. No complication occurred in 1 patient. Follow-up 1 to 17 months after surgery, gastroscopy did not find recurrence and metastasis. Conclusions Laparoscopic partial gastrectomy is a safe, feasible and effective method for the treatment of gastric stromal tumors of 1.5-3 cm in diameter. Gastric resection of gastric contents do not spill, less pollution and other advantages, may not place the abdominal drainage tube, it is worth clinical promotion.