| Background and Objective: Gastrointestinal stromal tumors(GISTs)are the most common tumors which origin from gastrointestinal mesenchymal.GISTs have been misclassified as leiomyomas,because of the microscopic appearance of spindle cells.In 1998,Kindbolm.et al [1] first proposed that GISTs may come from the interstitial cells of Cajal in the gastrointestinal tract.Because GISTs are similar to Cajal interstitial cells in pathology,molecular biology and immunology[2-5],the opinion that gastrointestinal stromal tumors originate from Cajal interstitial cells is recognized by most scholars.Recent studies have found that gastrointestinal stromal tumors may be derived from gastrointestinal stem cells[6].Gastrointestinal stromal tumors account for about 70% of gastrointestinal mesenchymal tumors[7].GISTs are most common in the stomach,and they can also occur in the gallbladder,pancreas,mesentery,retroveal,bladder,and uterus.Gastrointestinal stromal tumors are tumors that are between benign and malignant with a potential malignant tendency.GISTs occur mainly in middle-aged and elderly patients aged from 40 to 70.Its clinical manifestations lack specificity,and its diagnosis relies mainly on pathological examination and immunohistochemistry.In the past,gastrointestinal stromal tumors were treated by open surgery,and recent years,with the continuous development of therapeutic techniques,laparoscopic and digestive endoscopy are gradually applied to the treatment of gastrointestinal stromal tumors.This thesis will evaluate the efficacy of digestive endoscopy and laparoscopic resection by retrospective study,which will provide a reference for the choice of surgical methods.Methods: All intraoperative and postoperative statistics of 88 patients with upper gastrointestinal tract stromal tumors who admitted to the Department of Gastroenterology and Department of General surgery were analysed retrospectively.A T-test of independent samples of the numerical variables between the two groups,a Pearson test for the correlation between the two sets of data,and a covariance analysis of the two sets of data when the variable need to be excluded.Results: There was no significant difference in age and gender between the endoscopic treatment group and the laparoscopic surgery group.The tumor size of the endoscopic treatment group was significantly smaller than that of the laparoscopic surgery group(p=0.000).The covariance analysis was used to exclude the factor of n the tumor size and there was statistically difference in the operation time between the two groups(p=0.037).The number of postoperative hospital stays in the endoscopic treatment group(7.67±2.88 days)was significantly shorter than that in the laparoscopic surgery group(11.38±6.58 days)(p=0.001),but there was no significant difference in body temperature between the two groups.In very low risk and low risk gastrointestinal stromal tumors,the operation time and hospital stay in the endoscopic group were significantly shorter than those in the laparoscopic group.In the endoscopic treatment group and the laparoscopic surgery group,the operative time,the first day of postoperative body temperature,and the length of hospital stay were compared according to the tumor site.The results showed that the corpuscle group postoperative hospital stay(10.20±2.29 days)in laparoscopic group was longer than that in the fundus group(9.00±0.85 days)(p=0.044),and no significant difference was found in the rest.Conclusion: Laparoscopic surgery is more commonly used in patients with large tumors.Endoscopic treatment has certain advantages in the treatment of GTSTs with very low risk and low risk.The main manifestations are the operation time and the number of days in hospital after operation.Compared with laparoscopic surgery,there is no significant difference in intraoperative and postoperative complications. |
PDF Full Text Request