PDF(Pubmed)
Abstract：
Gastrointestinal stromal tumors (GISTs), the most common mesenchymal tumors in the gastrointestinal tract, are increasingly treated with minimally invasive surgeries. Developed techniques include laparoscopic, endoscopic, and hybrid methods for gastric GIST resection. Our study, focusing on single-incision laparoscopic intragastric resection for gastric GISTs, aims to evaluate its safety, efficacy, and long-term outcomes. In a retrospective study of GIST surgery involving 14 patients who underwent single-incision laparoscopic intragastric resections, we analyzed and compared their preoperative demographics, American Society of Anesthesiologists (ASA) scores, tumor size, neoadjuvant treatment, operation duration, hospital stay, mitotic and Ki-67 indexes, and histological features with those of patients who underwent open and laparoscopic wedge resections, to assess the impact on both survival and disease-free survival. Average operation time was 93.07 minutes (range 81-120 minutes). Average blood loss: 67 ± 20 mL (range 40-110 mL). Postoperative hospital stay averaged 6.79 days (range 4-16 days). Strong correlations were observed between preoperative and pathological tumor sizes (P = .001, P < .001). Survival analysis indicated a significant association with ASA scores (P = .031), but not with mitotic index, Ki-67, or tumor size. Average survival was 80.57 months, with no recurrence or metastasis during follow-up. Based on our experience, the single-incision laparoscopic intragastric resection method emerges as a highly efficient, timesaving, and gentle oncological procedure, providing a safe and minimally invasive alternative resulting in shorter hospital stays and excellent long-term outcomes with minimal recurrence. For more definitive conclusions, larger, multicenter, and prospective studies are recommended.
摘要：
胃肠道间质瘤（GIST），胃肠道中最常见的间充质肿瘤，越来越多地接受微创手术治疗。开发的技术包括腹腔镜，内窥镜,和胃GIST切除术的混合方法。我们的研究,以单切口腹腔镜胃内切除术为重点，旨在评估其安全性，功效,和长期结果。在一项涉及14例接受单切口腹腔镜胃内切除术的GIST手术的回顾性研究中，我们分析并比较了他们的术前人口统计学，美国麻醉医师协会（ASA）评分，肿瘤大小,新辅助治疗,操作持续时间,住院,有丝分裂和Ki-67指数，以及接受开放和腹腔镜楔形切除术的患者的组织学特征，评估对生存率和无病生存率的影响。平均手术时间为93.07分钟（范围81-120分钟）。平均失血量：67±20mL（范围40-110mL）。术后住院时间平均为6.79天（4-16天）。术前肿瘤大小和病理大小之间观察到强烈的相关性（P=.001，P<.001）。生存分析表明与ASA评分显著相关(P=.031)，但没有有丝分裂指数，Ki-67或肿瘤大小。平均生存期为80.57个月,随访期间无复发或转移。根据我们的经验,单切口腹腔镜胃内切除术方法是一种高效的，节省时间,温和的肿瘤学程序，提供安全和微创的替代方案，从而缩短住院时间和出色的长期结局，同时复发率最低。对于更明确的结论，较大,多中心，并建议进行前瞻性研究。
