Objective To explore the applying value of laparoscopic partial gastrectomy for gastric stromal tumors. Methods The clinical data of 22 patients with gastric stromal tumors between July 2007 and December 2009 in this hospital were analyzed retrospectively. And the laparoscopic resection was performed in all the patients. Results The laparoscopic resections were performed successfully in all the patients, and the tumors were completely resected. The length of operative incision on abdominal wall was 4－6 cm with average 5.3 cm. The mean operation time was 70 min. Postoperative recovery was smooth, no procedure related complications happened. The mean hospital stay was 7.2 d. Specimens of 20 cases were with CD117 (+), and 15 with CD34 (+) by immunohistochemistry. No recurrence or metastasis happened with average follow-up of 13 months (2－23 months). Conclusion Laparoscopic partial gastrectomy for gastric stromal tumors could be performed safely, postoperative recovery quickly and effectively with the advantage of minimal invasiveness.
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.
Objective To discuss the clinical application of totally laparoscopic surgery combined with intraoperative removed the specimen through the oral in treatment for gastric stromal tumor. Methods The clinical data of 20 patients diagnosed gastric stromal tumor and performed totally laparoscopic surgery combined with intraoperative removed the specimen through the oral in treatment for gastric stromal tumor from January 2007 to August 2009 in our hospital were analyzed retrospectively. Results All the cases were performed successfully laparoscopic operation. The operation time was （110±35） min， intraoperative bleeding was （60±15） ml，postoperative hospital stay was （6.5±1.2） d. No postoperative complications occurred. There were 19 cases no relapse during 0.5-2.5 years with (1.8±0.2) years of follow-up. One patient with recurrence was performed the laparoscopic proximal subtotal gastrectomy. Conclusions Totally laparoscopic surgery combined with intraoperative removed the specimen through the oral in treatment for gastric stromal tumor is safe， feasible， and minimally invasive for patients due to its clearness of dissection， less bleeding， and removed the specimen through natural channel.
ObjectiveTo investigate the relationship between preoperative C-reactive protein (CRP)/albumin ratio (CAR) and National Institutes of Health (NIH) risk classification in patients with gastric stromal tumors.MethodsClinical data of 108 patients with gastric stromal tumors admitted to the First Affiliated Hospital of Kunming Medical University from February 2010 to November 2016 were retrospectively collected. With the median of CAR as the critical value, patients were divided into high CAR group (CAR>0.048) and low CAR group (CAR≤0.048). Then observed the general clinicopathological characteristics and survival status of patients with higher and lower CAR value.ResultsThere were significant differences in NIH classification, tumor diameter, and mitosis between the high CAR group and low CAR group (P<0.05). Compared with the low CAR group, the tumors in the high CAR group had larger diameter, higher mitotic figure, and higher NIH grade. Survival analysis showed that the prognosis of the low CAR group was better than that of the high CAR group (χ2=15.152, P<0.001).ConclusionsCAR is closely related to the malignant index and NIH risk classification of gastric stromal tumors. It can be used as an index for evaluating the malignant degree of gastric stromal tumors, and it is expected to be an important reference factor for clinical NIH risk classification and prognosis.
Objective To compare the quality of life after laparoscopic and open surgery for gastric stromal tumor patients. Methods We collected the data of the patients undergoing the gastric stromal tumor surgery from May 2011 to August 2016 in West China Hospital of Sichuan University, and compared the basic data, complications, micturition time, hospital stay time, bleeding volume and hospitalization expenses. SF-36 scale was used to evaluate the quality of life. Then, SPSS 19.0 software was used for data analysis. Results Eighty nine patients involving 31 laparoscopic patients and 58 open surgery patients were included. There was no statistical significance in basic line between two groups. The laparoscopic group had shorter micturition time and hospital stay time, less intraoperative bleeding and lower hospitalization costs, the differences between two groups were statistically significant (P<0.05). But there were no significant differences between two groups in the operation time and postoperative complication rate. The SF-36 quality of life scale of laparoscopic group and open surgery group were 737.7±68.3 and 665.1±138.1, respectively. The laparoscopic surgery group had higher scores in validity (VT), social function (SF) and mental health (MH) than those in open surgery group with significant differences (P<0.05). Conclusion Laparoscopic surgery is safe and effective for the patients with stromal tumor. Patients in laparoscopic group have shorter recovery time and higher quality of life than open surgery group. Due to the limited of study design, more high quality studies are needed to verify above conclusion.
ObjectiveTo investigate the feasibility and safety of laparoscopic resection in treatment of gastric stromal tumors at difficult sites.MethodsA retrospective analysis of 64 cases of gastric stromal tumors at the difficult sites in Renmin Hospital of Wuhan University from January 2013 to October 2018 was performed. According to the patient’s surgical procedure, 64 cases were divided into two groups, there were 26 cases in the laparoscopic group and 38 cases in the open group. The clinical pathology data, surgical indexes, and follow-up results of the two groups were compared.ResultsAll the operations were successfully completed, and the patients in the laparoscopic group did not conversate to open surgery. There were no complications such as postoperative hemorrhage, anastomotic leakage, cardia or pyloric stenosis, abdominal infection, and no positive margin and tumor rupture. The postoperative venting time, visual analogue scale of pain on 1 day after operation, and hospital stay in the laparoscopic group were better than those of the open group (P<0.05). There were no local recurrence cases in the two groups. In the open group, two cases of middle-high risk patients did not take imatinib according to the doctor’s advice and suffered from liver metastasis. In the laparoscopic group, one case of high-risk patient did not take medicine regularly and suffered from liver metastasis too. There was no significant difference in survival situation between the two groups (P>0.05).ConclusionLaparoscopic resection is safe and feasible for gastric stromal tumors with a diameter of less than 5 cm, it has shorter recover time and shorter hospital stay than open surgery, which can be clinically promoted.
Objective To investigate the feasibility and safety of laparoscopic operation of gastric and gastroesophageal junction diseases. Methods Between May 2004 and June 2009, 59 patients with gastric and gastroesophageal diseases were treated laparoscopically. The operative methods and maneuvers were evaluated and perioperative interventions, complications and efficacy of patients were analyzed. Results All operations were successfully completed laparoscopically except for one patient with gastric cancer who required a conversion to open surgery. No short-term complications occurred in all cases. No port transplant metastasis occurred for the patients with gastric cancer after an average of 36 months (1-60 months) follow-up. One patient died of liver metastasis 12 months after operation. The 3-year survival rate was 93.3% (14/15). Conclusion Laparoscopic surgery of the gastric and gastroesophageal junction diseases is feasible and safe with minimal invasiveness, which is worth popularizing.
Objective To discuss the value of 64-slice spiral CT （MSCT） in diagnosis of gastric stromal tumor （GST）. Methods Thirty-two patients proved GST by surgery and pathology from May 2010 to August 2011 in West China Hospital, Sichuan University were classified by Fletcher malignancy degree classification，the CT features including the location，size，boundary，shape，density，growth pattern，metastases，and enhancement and its relationships to GST malignancy degree were analyzed retrospectively. Results All 32 cases were single lesion，the accuracy of CT in localization was 100%. Nine cases were intra-luminal，10 were extra-luminal，and 13 were both intra- and extra-luminal growth. Nine cases were in low degree group，with diameter＜5cm，round or oval in shape，clear border, homogenous density and enhancement （7/9）；Twenty-three cases were in high degree group，with diameter ≥5cm in 19 cases，irregular in shape and indistinct bourdry （18/23），heterogeneous density （20/23） with necrosis，ulcer was seen in 6 cases. Three cases in high malignance degree group showed pancreas and spleen involvements，2 cases of left diaphragm involvement，1 of omentum metastasis，2 of liver metastases，and 1 of lymph node metastasis. Conclusions MSCT is the optimal method to exam GST，there is correlation between the CT features and malignancy degree，MSCT is helpful for analyzing malignancy degree preoperation.