隋建++++++陈林昊++++++黄良祥

[摘要] 目的 探讨腹腔镜联合胃镜切除近贲门处胃间质瘤的疗效和可行性。方法 对该院2009年2月—2014年5月收治的60名采用腹腔镜联合胃镜切除胃间质瘤患者进行回顾性的分析。 结果 60名患者均在双镜联合下成功切除近贲门处的间质瘤，手术时间平均为110 min，术中平均出血量28.5 mL，术后平均住院天数为6.5 d。无1例出现感染、穿孔及出血等并发症。术后平均随访5～24个月，无1例出现肿瘤复发或转移，无1例出现吞咽困难、腹痛等症状，营养状况良好。 结论 腹腔镜联合胃镜治疗近贲门处胃间质瘤是安全和可行的。

[关键词] 双镜联合手术；腹腔镜；术中胃镜；胃间质瘤

[中图分类号] R656 [文献标识码] A [文章编号] 1674-0742（2015）01（a）-0008-02

Clinical Analysis of Combination of Laparoscopy and Gastroscopy in the Dissection of Gastric Stromal Tumors Near to the Cardia

SUI Jian CHEN Linhao HUANG Liangxiang

Department of Gastrointestinal Surgery， Provincial Clinical College of Fujian Medical University， Fuzhou， Fujian Province， 350001， China

[Abstract] Objective To evaluate the efficacy and feasibility of the combined laparoscopy and gastroscopy in the dissection of gastric stromal tumors near to the cardia. Methods The data of 60 patients who had undergone combined laparoscopy and gastroscopy in the dissection of gastric stromal tumors near to the cardia in our hospital from February 2009 to May 2014 were analyzed retrospectively. Results The procedure was successfully performed in all the 60 patients. The mean operation time was 110 minutes. The mean intraoperative blood loss was 28.5ml. The mean postoperative hospital stay was 6.5 days. None had infection， perforation， hemorrhage and other complications. The mean follow up time was 5 months to 2 years. All the patients had good nutrition， none of them had recurrence or metastasis of the tumor， dysphagia or bellyache. Conclusion The combination of laparoscopy and gastroscopy is safe and feasible for the gastric stromal tumors near to the cardia.

[Key words] Laparoscopic and gastroscopic cooperative surgery； Laparoscope； Intraoperative gastroscopy； Gastric stromal tumors

胃肠道间质瘤（Gastrointestinal Stromal Tumors，GISTs）是一类起源于胃肠道间叶组织的肿瘤，免疫组织化学表达CD117及CD34阳性[1]，胃间质瘤占全部胃肠道肿瘤发病率的1%，文献报道其发病率为（0.7～1.4）/105[2]。GISTs对于放化疗不敏感[3]，近10年来，腹腔镜胃肠外科飞速发展，腹腔镜胃间质瘤切除术在近几年来成为胃间质瘤切除的标准术式。但是对于位于近贲门处的胃间质瘤，如果肿瘤体积过大，或者过于接近贲门，切除后有可能导致贲门狭窄。相对于开放手术，腹腔镜缺乏对于肿瘤体积和边界的触觉反馈，因而术中有误伤贲门的风险。针对这个问题，对该院2009年2月—2014年5月收治的60例患者采用腹腔镜联合胃镜的方式切除近贲门的胃间质瘤，取得了良好的效果，现报道如下。

1 资料与方法

1.1 一般资料

该院选取的60例患者中23例为男……