| Objective:To analyze the clinical and pathological characteristics of gastric submucosal tumors(GSMTs),and to evaluate the safety and efficacy of endoscopic treatment for GSMTs compared with Laparoscopic treatment.Methods: A total of 91 patients with GSMTs who were diagnosed and treated by endoscopy or laparoscope were retrospectively selected from January 2015 to January 2012 in The First Affiliated Hospital of Xinjiang Medical University;61 of them were treated by endoscopy,30 were treated by laparoscope. Pathological examination was taked in all removed tumors,the tumors which could be the gastic stomal tumors(GSTs) were furtherly examed with the molecular biology technique of immunohistochemistry. To analyze the gender,age,reasons for treatment of the patient, tumor location, surgical procedures, operative time, blood loss, tumor size, postoperative hospital stay,hospitalization expenses.Results:1. In 91 cases, the patients revealed by physical examination accounted for 57.14%(52/91), with dyspepsia accounted for 7.70%(7/91),with acid reflux were accounted for 8.89%(8/91),with abdominal pain and abdominal discomfort each accounted for 6.60%( 6/91), with anemia and melena medical reasons each accounted for 1.06%(1/91); the tumors located at the stomach fund accounted for 52.75%(48/91), at the gastric corpus for 20.88%(19/91), at the gastric antrum for 16.48%(15/91),in cardia for 9.89%(9/91).After pathological and immunohistochemical analysis, 56 tumors were identified as gastric stromal tumor,and 46 of them in risk classification were at very low risk,4 were at low risk,4 were at mid-risk,2 were at high risk, risk classification is at very low risk and low risk group accounted for 89.29%(50/56),11 were leiomyoma,4 were Schwannoma,5 were lipoma,7 were heter otopic pancreas,5 were calcifying fibrous pseudotumor,2 were inflammatory fibroid polyps,and 1 was angiomatous proliferation;gastric stromal tumor at gastric fundus account for 73.21%(41/56),at gastric corpus for 10.71%(6/56), at gastric antrum for6%(6/56) and at cardia for 5.36%( 3/56).2.Compared with the laparoscopicgroup,the endoscopic group present horteroperationtime[55.86±11.407 min compared71.33±9.904 min,t=-4.563,P<0.01],1ess intraoperative blood loss[16.83±4.639 ml compared 26.33±4.806 ml,t=-6.400,P<0.01],less postoperative hospital stays[5.03±2.468 d compared 7.20±1.207,t=-2.170,P<0.01],and less hospitalization expenses[24779.43 ±6201.999 compared 45689.42 ± 10318.468, t=-8.422,P<0.001].The postoperative complications rate[3.27% compared 6.67%,X2=0.039,P>0.05] and operation successful rate[96.7% compared 86.67%,X2=1.870,P>0.05] had no statistical difference.It has no tumor recurrence or distant metastasis during the follow-up time in two group.Conclusions:1.GSMTs commonly lack for specific clinical symptoms;GMSTs are commonly locared at gastric fund and most of them are gastri stomal tumors,vast majority of gastric stromal tumors which diameter are less than 5cm in the risk classification are at very low risk and low risk;2.The curative effect of endoscopic treatment for gastric submucosal tumor is similar to laparoscopy, it is safe and effective.and it is less trauma,faster recovery, lower cost. |
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