Objective:To compare the clinical effect of total laparoscopic and open surgery for gastric stromal tumors≤5 cm in diameter and explore the application prospect of the laparoscopic surgery. Methods:Fifty-nine patients who underwent wedge resection of gastric stromal tumors in Department of General Surgery,the General Hospital of PLA from January 1,2010 to January 1,2015 were identified. Twenty-two of them were treated by laparoscopic resection,and the rest of the cases underwent laparotomy. The perioperative condition and prognosis for each surgical type were compared retrospectively. Results:There was no significant difference in gender composition,age,tumor site and maximum diameter between the two groups. Laparoscopic wedge resection was superior to laparotomy treatment in operation time [(53. 95±19. 59) min vs. (103. 84±21. 257) min,t=-8. 969,P<0. 001],blood loss [39. 41 (2-100) ml vs. 121. 35 (20-400) ml,Z=-4. 285,P<0. 001],time to first flatus [1. 91 (1-3) d vs. 3. 72 (2-5) d,Z=-4. 871,P<0. 001],time to liquid diet [2. 73 (2-4) d vs. 4. 38 (3-6) d,Z=-5. 319,P<0. 001],postoperative hospital stay [4. 55 (3-6) d vs. 7. 70 (5-10) d,Z=-6. 166,P<0. 001],change level of CRP [(3. 13±0. 97) mg/dl vs. (5. 48±1. 98) mg/dl,t=-6. 10,P<0. 001],IL-6 [(8. 69±2. 52) ng/L vs. (14. 87±3. 81) ng/L,t=-6. 77,P<0. 001] after 4 h of postoperation and pain score (3. 64±0. 902 vs. 5. 43±1. 068,t=-6. 604,P<0. 001). During the short-term follow-up of 6-36 months,no recurrence or distant metastasis were found. Conclusions:Com-pared with laparotomy treatment,total laparoscopic wedge resection for gastric stromal tumors ≤5 cm in diameter permits minimized surgical trauma,reduced pain and shorter recovery time,meanwhile the postoperative recurrence and metastasis rates do not increase. According to our comparison,total laparoscopic wedge resection for gastric stromal tumors may have a good application prospect in fu-ture.%目的：：比较全腹腔镜与开腹手术治疗直径≤5 cm的胃间质瘤的临床疗效,探讨腹腔镜手术在胃间质瘤治疗中的应用前景。方法：选取2010年1月1日至2015年1月1日行胃间质瘤楔形切除术的59例患者,其中全腹腔镜楔形切除术22例(腔镜组),开腹楔形切除术37例(开腹组)。对比两组围手术期相关指标及预后情况。结果：两组在性别、年龄、肿瘤部位及最大直径等方面差异无统计学意义(P>0.05),与开腹组相比,腹腔镜组手术时间短[(53.95±19.59) min vs.(103.84±21.257) min,t=-8.969,P<0.001],术中失血量少[39.41(2-100) ml vs.121.35(20-400) ml,Z=-4.285,P<0.001],术后恢复排气时间早[1.91(1-3) d vs.3.72(2-5) d,Z=-4.871,P<0.001],术后开始进食时间早[2.73(2-4) d vs.4.38(3-6) d,Z=-5.319,P<0.001],术后住院时间短[4.55(3-6) d vs.7.70(5-10) d,Z=-6.166,P<0.001],术后4 h C反应蛋白升高幅度小[(3.13±0.97) mg/dl vs.(5.48±1.98) mg/dl,t=-6.10,P<0.001],术后4 h白介素-6升高幅度小[(8.69±2.52) ng/L vs.(14.87±3.81) ng/L,t=-6.77,P<0.001],疼痛感觉轻[(3.64±0.902) vs.(5.43±1.068),t=-6.604,P<0.001]。随访6~36个月,均未出现复发及远处转移。结论：与传统开腹手术相比,全腹腔镜胃间质瘤楔形切除术具有创伤小、疼痛轻、康复快等优势,术后复发转移率并未明显增加,在胃间质瘤的临床治疗中具有良好的应用前景。
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