目的：研究内镜联合腹腔镜对胃肠道间质瘤进行切除的可行性及其临床疗效。方法选择2008年4月至2012年4月间诊治的102例胃肠道间质瘤患者,其中男性60例,女性42例；年龄在20~79岁,平均为(57.8±6.7)岁。62例为胃间质瘤,行腹腔镜联合胃镜治疗；40例为肠道间质瘤,运用腹腔镜联合肠镜进行治疗。所有患者围手术期均行胃肠减压、补充液体、营养支持以及预防性应用抗生素。待肠道功能恢复后,拔除胃管。短期内进行流质饮食,逐步过渡到正常饮食。对所有患者进行半年以上的随访观察。结果所有患者均成功实施手术,病变部位定位准确,手术过程所需时间为40~80min,术中出血量在5~30ml,无中转开腹手术的患者；术后无吻合口出血及吻合口漏等并发症。所有患者随访半年,均无肿瘤复发。结论两镜联合治疗胃肠道间质瘤,疗效明确,手术的安全性高,同时降低了开腹手术给患者带来的痛苦和损伤,是目前治疗胃肠道间质瘤的较为理想的一种方法。%Objective To explore the feasibility of endoscopic and laparoscopic resection of gastro-intestinal malignant stromal tumors and examine its clinical efficacies.Methods From April 2008 to A-pril 2012,a total of 102 patients of gastrointestinal malignant stromal tumors underwent laparoscopic and endoscopic operations.There were gastric malignant stromal tumor (n=62)and intestinal malig-nant stromal tumor (n=40).The postoperative measures included gastrointestinal decompression, supplement liquid,nutritional supports and preventive antibiotics.There was a recovery of bowel function after extubation.Short-term liquid diet was gradually switched to a normal diet.The follow-up period was over half a year.Results All patients were successfully operated.Accurate positioning was achieved for all lesions.The operative duration was 40-80 min and blood loss volume 5-30 ml. There was no conversion into open operation.And no postoperative occurrence of anastomotic bleeding or leakage was noted.None of them had tumor recurrence.Conclusions For malignant gastrointestinal stromal tumors,combined approach offers a painless and mini-invasive alternative and it is worthy of wider clinical popularization.
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