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.
目的探讨肝细胞癌合并脾功能亢进患者同期行肝癌切除和脾切除的安全性及可行性。 方法回顾性分析2001年11月至2012年4月期间笔者所在医院收治的52例肝细胞癌合并脾功能亢进同期施行肝癌切除和脾切除患者的临床资料。 结果肝癌切除联合脾切除19例，肝癌切除联合脾切除加贲门周围血管离断术33例。手术时间（249.63±40.90）min（182～340 min），术中出血量（580.77±260.31）mL（200～1 700）mL。全组无死亡病例，术后并发症包括：胸腔积液11例，肺内感染3例，肝断面感染3例，胆汁漏1例，切口感染2例，高胆红素血症3例，门静脉系统血栓形成22例，均经保守治疗后好转。术后第14天，患者的白细胞和血小板计数分别由术前的（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）；术后红细胞计数变化不明显，甚至有轻度下降。 结论对于肝细胞癌合并脾功能亢进患者，选择合适的病例同期行肝癌切除和脾切除是安全可行的，而且脾切除有助于缓解脾功能亢进。