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首页> 外文期刊>Surgical Endoscopy >Lessons learned from laparoscopic treatment of gastric and gastroesophageal junction stromal cell tumors.
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Lessons learned from laparoscopic treatment of gastric and gastroesophageal junction stromal cell tumors.

机译：腹腔镜治疗胃和胃食管交界处基质细胞瘤的经验教训。

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摘要

BACKGROUND: Stromal cell tumors of the gastric and gastroesophageal junction are rare neoplasms that traditionally have been resected for negative margins using an open approach. This study aimed to evaluate the efficacy laparoscopic resection of gastric and gastroesophageal stromal cell tumors and the lessons learned from experience with this method. METHODS: This retrospective review evaluated all patients who underwent laparoscopic resection of gastric or esophageal stromal cell tumors at a tertiary referral center between December 2002 and March 2005. Medical records were reviewed with regard to patient demographics, preoperative evaluation, operative approach, tumor location and pathology, length of operation, complications, and length of hospital stay. RESULTS: A total of 12 consecutive patients with a mean age of 55 +/- 5.9 years were treated. Preoperative endoscopic ultrasound (EUS) was performed for 11 of 12 patients with a diagnostic accuracy of 100%, whereas EUS-guided fine-needle aspirationwas performed for 10 of 12 patients with a diagnostic accuracy of 50%. Four patients with symptomatic gastroesophageal junction leiomyomas were treated with enucleation and Nissen fundoplication. Eight patients were treated with laparoscopic wedge resection of gastric lesions. Complete R0 resection was achieved for all the patients undergoing laparoscopic resection. Intraoperative endoscopy was performed for four patients and resulted in shorter operative times. The average operative time for this entire series was 169 +/- 17 min: 199 +/- 24 min for the first six cases and 138 +/- 19 min for the last six cases. The median hospital length of stay was 2 days. One patient with esophageal leiomyoma had persistent dysphagia at the 12-month follow-up assessment. There were no other complications and no deaths in this series of patients. CONCLUSIONS: Laparoscopic resection of gastric and gastroesophageal junction stromal cell tumors may be performed safely with low patient morbidity. This approach can achieve adequate surgical margins and lead to short hospital stays. Improvements in the technique have led to shorter operative times.
机译：背景：胃和胃食管连接处的基质细胞肿瘤是罕见的肿瘤，传统上已使用开放方法切除了负缘。这项研究旨在评估腹腔镜手术切除胃和胃食管间质细胞瘤的效果，以及从这种方法的经验中吸取的教训。方法：这项回顾性研究评估了2002年12月至2005年3月间在三级转诊中心接受腹腔镜切除胃或食管间质细胞瘤的所有患者。对患者的人口统计学，术前评估，手术方法，肿瘤位置和病理，手术时间，并发症和住院时间。结果：共治疗了12例平均年龄为55 +/- 5.9岁的患者。对12例患者中的11例进行了术前内镜超声检查（EUS），诊断准确性为100％，而对12例患者中的10例进行了EUS引导的细针抽吸术，诊断准确性为50％。对4例有症状的胃食管连接平滑肌瘤患者行摘除术和尼森胃底折叠术治疗。对8例患者行腹腔镜楔形切除胃部病变。所有接受腹腔镜切除的患者均完成了R0切除。术中对四名患者进行了内窥镜检查，从而缩短了手术时间。整个系列的平均手术时间为169 +/- 17分钟：前六例为199 +/- 24分钟，后六例为138 +/- 19分钟。中位住院时间为2天。在12个月的随访评估中，一名食管平滑肌瘤患者持续存在吞咽困难。该系列患者没有其他并发症，也没有死亡。结论：腹腔镜切除胃和胃食管交界处间质细胞瘤可安全地进行，患者发病率低。这种方法可以达到足够的手术余量，从而缩短住院时间。该技术的改进已缩短了手术时间。

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