ObjectiveTo compare the results of laparoscopic-endoscopic cooperative resection and open surgery for gasric stromal tumor. MethodsFrom January 2010 to March 2015, the clinical data of 56 cases undergoing laparoscopic resection for gasric stromal tumor and 53 cases of traditional operation selected during the same period were retrospectively compared. ResultsThere was no significant difference between two groups in patient's gender, age, body weight, size of tumor, tumor staging, method of operation, intraoperative conditions, postoperative overall complications, local recurrence, and distant metastasis. There were 1 case with the rupture of tumor and 1 case of open surgery transforming in laparoscopic group. In another group, there was the absence of the rupture of tumors. There was no mortality, stomach bleeding, stenosis or leakage occurred between two groups. In laparoscopic group, there were less operative blood loss and abdominal drainage, shorter time of postoperative anal exhaust time, fewer anodyne, a reduction of hospital stay than in convention operation group.However, laparoscopic resection required greater hospital costs and longer operative time. There were significant differences between two groups (P < 0.05). Conciusions With advantages of less blood loss and quicker recovery as compared to conventional operation. Laparoscopic-endoscopic cooperative resection for gasric stromal tumor has similar effect when it is performed by well selection of cases, skilled surgeon with experience on open resection for surgical treatment of gastric stromal tumor.
目的探討肝細胞癌合并脾功能亢進患者同期行肝癌切除和脾切除的安全性及可行性。 方法回顧性分析2001年11月至2012年4月期間筆者所在醫院收治的52例肝細胞癌合并脾功能亢進同期施行肝癌切除和脾切除患者的臨床資料。 結果肝癌切除聯合脾切除19例，肝癌切除聯合脾切除加賁門周圍血管離斷術33例。手術時間（249.63±40.90）min（182～340 min），術中出血量（580.77±260.31）mL（200～1 700）mL。全組無死亡病例，術后并發癥包括：胸腔積液11例，肺內感染3例，肝斷面感染3例，膽汁漏1例，切口感染2例，高膽紅素血癥3例，門靜脈系統血栓形成22例，均經保守治療后好轉。術后第14天，患者的白細胞和血小板計數分別由術前的（3.19±1.59）×109/L和（53.96±18.94）×109/L升至（8.86±5.06）×109/L和（464.90±189.27）×109/L（P＜0.05）；術后紅細胞計數變化不明顯，甚至有輕度下降。 結論對于肝細胞癌合并脾功能亢進患者，選擇合適的病例同期行肝癌切除和脾切除是安全可行的，而且脾切除有助于緩解脾功能亢進。