Serosal and muscular layers incision and use of submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors

Xie Jianming, Zhang Moucheng, Yin Yongfang, Zhang Zhiping, Zhou Jiaming, Yan Zhilong
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Abstract

Objective To explore the feasibility and clinical efficacy of serosal muscular layers incision and submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors(GIST). Methods 28 patients with gastric GIST underwent serosal muscular layers incision and submucosal layers exfoliation technique under laparoscopic surgery. Patients′clinicopathologic characteristics, operative outcomes, postoperative complications, and follow up results were analyzed retrospectively. Results Surgery was successfully completed in all patients, and no one was converted to open surgery.The average operation time was (66±15) min, and the intra operative blood loss was (16±10) ml, the time of passage of gas by anus after operation was (20±10)h, the time starting liquid diet was(2.5±1.6)d, and the length of postoperative hospital stay was (7±3)d. One patient had delayed gastric emptying, one had incisional infection. All the specimen had complete pseudocapsule and negative margin. pathology was all gastric GIST. After a median 22 months followed up, no recurrence or metastasis were found. Conclusion Serosal muscular layers incision and submucosal layers exfoliation under laparoscopic surgery is a safe and feasible procedure for treating gastric GIST. Key words: Gastric gastrointestinal stromal tumors; Laparoscopy; Operative procedures, surgical
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浆膜及肌肉层切开及粘膜下层剥脱技术在腹腔镜胃胃肠间质瘤手术中的应用
目的探讨浆膜肌层切开和黏膜下层剥离技术在腹腔镜胃胃肠道间质瘤(GIST)手术中的可行性和临床疗效。方法对28例胃GIST患者在腹腔镜下采用浆膜肌层切开和粘膜下层剥离术。回顾性分析患者的临床病理特征、手术结果、术后并发症和随访结果。结果所有患者均成功完成手术,无一例转为开放手术。平均手术时间为(66±15)min,术中出血量为(16±10)ml,术后肛门通气时间为(20±10)h,开始流质饮食时间为(2.5±1.6)d,术后住院时间为(7±3)d。一名患者胃排空延迟,一名患者切口感染。所有标本均具有完整的假包膜和阴性边缘。病理均为胃GIST。经过平均22个月的随访,没有发现复发或转移。结论腹腔镜下浆膜肌层切开黏膜下层剥离术是治疗胃GIST安全可行的方法。关键词:胃胃肠道间质瘤;腹腔镜;手术程序,外科
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