Abstract：
BACKGROUND: Laparoscopic resection of gastric gastrointestinal stromal tumors (GISTs) is technically feasible and associated with favorable outcomes. We compared the clinical efficacy of hand-assisted laparoscopic surgery (HLS) and total laparoscopic surgery (TLS) for gastric GISTs.
METHODS: We retrospectively analyzed the clinical data of 69 consecutive patients diagnosed with a gastric GIST in a tertiary referral teaching hospital from December 2016 to December 2020. Surgical outcomes were compared between two groups.
RESULTS: Fifty-three patients (TLS group: n = 36; HLS group: n = 17) were included. The mean age was 56.9 and 58.1 years in the TLS and HLS groups, respectively. The maximum tumor margin was significantly shorter in the HLS group than in the TLS group (2.3 ± 0.9. vs. 3.0 ± 0.8 cm; P = 0.004). The operative time of the HLS group was significantly shorter than that of the TLS group (70.6 ± 19.1 min vs. 134.4 ± 53.7 min; P < 0.001). The HLS group had less intraoperative blood loss, a shorter time to first flatus, and a shorter time to fluid diet than the TLS group (P < 0.05). No significant difference was found between the groups in the incidence or severity of complications within 30 days after surgery. Recurrence or metastasis occurred in four cases (HLS group; n = 1; TLS group; n = 3).
CONCLUSIONS: This study demonstrated that compared with TLS, HLS for gastric GISTs has the advantages of simpler operation, shorter operative time, and faster postoperative recovery.
METHODS: We retrospectively analyzed the clinical data of 69 consecutive patients diagnosed with a gastric GIST in a tertiary referral teaching hospital from December 2016 to December 2020. Surgical outcomes were compared between two groups.
RESULTS: Fifty-three patients (TLS group: n = 36; HLS group: n = 17) were included. The mean age was 56.9 and 58.1 years in the TLS and HLS groups, respectively. The maximum tumor margin was significantly shorter in the HLS group than in the TLS group (2.3 ± 0.9. vs. 3.0 ± 0.8 cm; P = 0.004). The operative time of the HLS group was significantly shorter than that of the TLS group (70.6 ± 19.1 min vs. 134.4 ± 53.7 min; P < 0.001). The HLS group had less intraoperative blood loss, a shorter time to first flatus, and a shorter time to fluid diet than the TLS group (P < 0.05). No significant difference was found between the groups in the incidence or severity of complications within 30 days after surgery. Recurrence or metastasis occurred in four cases (HLS group; n = 1; TLS group; n = 3).
CONCLUSIONS: This study demonstrated that compared with TLS, HLS for gastric GISTs has the advantages of simpler operation, shorter operative time, and faster postoperative recovery.
摘要：
背景：腹腔镜切除胃胃肠道间质瘤（GIST）在技术上是可行的，并且具有良好的预后。我们比较了手助腹腔镜手术（HLS）和全腹腔镜手术（TLS）治疗胃GIST的临床疗效。
方法：回顾性分析某三级转诊教学医院2016年12月至2020年12月连续69例胃部GIST患者的临床资料。比较两组的手术效果。
结果：纳入53例患者（TLS组：n=36；HLS组：n=17）。TLS和HLS组的平均年龄为56.9岁和58.1岁，分别。HLS组的最大肿瘤切缘明显短于TLS组（2.3±0.9。vs.3.0±0.8cm;P=0.004)。HLS组的手术时间明显短于TLS组（70.6±19.1minvs.134.4±53.7分钟；P<0.001）。HLS组术中出血量较少，第一次排气的时间较短，与TLS组比较,补液时间短(P<0.05)。术后30天内，两组间并发症的发生率或严重程度无显著差异。复发或转移4例（HLS组，n=1；TLS组，n=3）。
结论：这项研究表明，与TLS相比，HLS的胃GIST具有操作简单的优点，手术时间更短，术后恢复更快。
方法：回顾性分析某三级转诊教学医院2016年12月至2020年12月连续69例胃部GIST患者的临床资料。比较两组的手术效果。
结果：纳入53例患者（TLS组：n=36；HLS组：n=17）。TLS和HLS组的平均年龄为56.9岁和58.1岁，分别。HLS组的最大肿瘤切缘明显短于TLS组（2.3±0.9。vs.3.0±0.8cm;P=0.004)。HLS组的手术时间明显短于TLS组（70.6±19.1minvs.134.4±53.7分钟；P<0.001）。HLS组术中出血量较少，第一次排气的时间较短，与TLS组比较,补液时间短(P<0.05)。术后30天内，两组间并发症的发生率或严重程度无显著差异。复发或转移4例（HLS组，n=1；TLS组，n=3）。
结论：这项研究表明，与TLS相比，HLS的胃GIST具有操作简单的优点，手术时间更短，术后恢复更快。
