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| 1 | 腹腔镜修补术与胃大部分切除治疗急性胃穿孔的效果比较显示文摘目的:比较腹腔镜修补术与胃大部分切除术治疗急性胃穿孔的效果。方法:以2012年2月~2015年10月在我院接受治疗的急性胃穿孔患者为观察对象,根据其手术方式分为腹腔镜修补术组和胃大部切除组。比较两组围手术期一般情况(手术时间、术中出血量、肛门排气时间)、手术前后症状积分(肠鸣音积分、腹胀痛积分及胃肠道反应积分),并测定手术前后胃蛋白酶(PGⅠ和PGⅡ)和胃肠激素(GAS、VIP)水平。结果:两组患者的手术时间无明显差别(P>0.05),腹腔镜组术中出血量较开腹组少,肛门排气时间较开腹组短,差异具有统计学意义(P<0.05);两组患者手术前肠鸣音积分、腹胀痛积分及胃肠道反应积分较高,且无明显差别(P>0.05),手术后,两组患者的上述积分水平均下降,但腹腔镜组下降更为明显(P<0.05);两组患者手术前胃蛋白酶(PGⅠ和PGⅡ)及胃肠激素(GAS、VIP)水平无明显差别(P>0.05),手术后,两组患者的胃蛋白酶及胃肠激素水平均有所升高,腹腔镜组升高更为明显(P<0.05)。结论:腹腔镜修补术对急性胃穿孔患者创伤小,且术后恢复快,具有较高的临床应用价值。 | 黄志敏 尹鹤松 | 2017 | 现代医学2017，45，6： | 35 |
| 2 | 上消化道黏膜下肿瘤内镜治疗的关键问题分析显示文摘目的探讨不同部位上消化道黏膜下肿瘤(SMT)内镜治疗的必要性及内镜治疗术式选择。方法回顾2012年1月至2013年10月在上海长海医院消化内镜中心接受内镜治疗的306例上消化道SMT患者的临床资料,重点分析SMT的部位分布特征、病理类型、内镜术式选择等关键问题。结果306例病灶中,食管SMT55例(18.0%),胃SMT244例(79.7%),十二指肠SMT7例(2.3%)。病理类型:平滑肌瘤142例(46.4%),胃肠间质瘤(GIST)114例(37.3%),异位胰腺15例(4.9%),脂肪瘤14例(4.6%),神经内分泌肿瘤7例(2.3%),其他类型14(4.6%)。食管SMT中平滑肌瘤比例为85.4%,GIST比例为5.4%;贲门SMT中平滑肌瘤比例为78.8%,GIST比例为12.1%;胃底SMT中平滑肌瘤比例为28.7%,GIST比例为69.O%;胃体SMT中平滑肌瘤比例为38.6%,GIST比例为45.5%;胃窦SMT中平滑肌瘤比例为25.7%,GIST比例为14.3%;十二指肠SMT中平滑肌瘤比例为14.3%,GIST比例为28.6%。306例病灶中,接受内镜黏膜下挖除术(ESE)治疗242例(79.1%),内镜黏膜下隧道切除术(STER)28例(9.2%),内镜全层切除术(EFR)25例(8.2%)。食管SMT治疗中ESE54.5%、STER40%,胃SMT治疗中ESE84.4%、STER2.5%、EFR10.2%,十二指肠SMT均行ESE。STER主要应用于食管(78.6%),EFR主要应用于胃底(72.0%)、胃体(24.0%)。结论食管、贲门、胃窦部位SMT以良性居多,如无明显相关症状,可定期内镜随访。胃底、胃体SMT以GIST为主,且存在中危、高危病灶,应选择内镜治疗。食管SMT选择STER较为安全,但不适合较大的病变;胃SMT以ESE为主,起源较深的胃底、胃体病变必要时应选择EFR;十二指肠SMT以ESE为主。当内镜治疗风险高或切除困难时,应选择腹腔镜或外科手术治疗。 | 王伟 施新岗 金震东 李兆申 | 2017 | 中华消化内镜杂志2017，34，11： | 13 |
| 3 | 内镜切除与腹腔镜手术治疗胃间质瘤临床对比分析显示文摘目的:比较内镜切除与腹腔镜手术治疗直径为2~5cm胃间质瘤的临床对比分析,探讨消化内镜治疗较大胃间质瘤的临床应用价值。方法:收集2013年6月至2018年6月我院病理诊断为胃间质瘤的78例患者临床资料,其中内镜组45例,腹腔镜组33例,比较二者的一般资料、围手术期及随访等情况。结果:两组在年龄、性别、肿瘤生长部位、肿瘤危险程度分级上差异无统计学意义(P>0.05);内镜组肿瘤直径[(3.13±0.83)cm]较腹腔镜组[(3.67±1.03)cm]小,差异有统计学意义(P<0.05)。两组在完整切除率上差异无统计学意义;内镜组手术时间、术后排气时间、术后住院时间、住院总费用均小于腹腔镜组,差异有统计学意义(P<0.05);内镜组并发症发生率为17.8%,较腹腔镜组(6.1%)高,差异有统计学意义(P<0.05)。内镜组术后随访(22.4±15.4)个月,腹腔镜组术后随访(24.7±17.5)个月,差异无统计学意义(P>0.05)。随访期间,内镜组均未发生复发、转移和死亡,腹腔镜组1例术后14个月复发,两组在复发、转移及死亡率上差异无统计学意义(P>0.05)。结论:内镜下治疗2~5cm直径的胃间质瘤创伤小、恢复快、疗效好,预后和腹腔镜无差异,但是内镜组手术主动穿孔与被动穿孔发生率较高,但均能成功缝合,不影响预后及经济性,内镜下治疗较大直径的胃间质瘤有望成为开腹手术及腹腔镜手术之外的方式之一,更广泛应用于临床。 | 龚玉婷 陈志芬 | 2019 | 现代肿瘤医学2019，27，24： | 12 |
| 4 | Laparoscopic versus Open Resection of Small Bowel Gastrointestinal Stromal Tumors: Systematic Review and Meta-analysis显示文摘 | Ke Chen Bin Zhang Yue-Long Liang Lin Ji Shun-Jie Xia Yu Pan Xue-Yong Zheng Xian-Fa Wang Xiu-Jun Cai | 2017 | Chinese Medical Journal2017，，13： | 7 |
| 5 | 胃肠道间质瘤治疗进展显示文摘胃肠道间质瘤(GIST)是消化系统最常见的间叶性肿瘤,早期临床症状不典型,难以诊断。手术切除是GIST患者的主要治疗方式。随着新型医疗器械的出现和内镜医师技术的不断提高,GIST的治疗呈现微创化、多样化及跨学科合作的特点。但部分GIST患者手术治疗后复发率仍较高。近年关于基因水平的研究不断深入,靶向药物的运用对预防GIST患者的复发和转移起关键作用。目前内镜治疗GIST的安全性和有效性仍存在争议,且GIST的发病机制也尚未完全阐明,未来需深入研究。 | 李龙泉 王永庆 马明 黄田 梁元 张惠芸 黄绦壁 孙蔚明 王玉平 | 2021 | 医学综述2021，27，8： | 6 |
| 6 | Clinical evaluation of endoscopic resection for treatment of large gastric stromal tumors显示文摘BACKGROUND Gastric stromal tumor is a digestive tract mesenchymal tumor with malignant potential, and endoscopic techniques have been widely used in the treatment of gastric stromal tumors, but there is still controversy over their use for large gastric stromal tumors(≥ 3 cm).AIM To evaluate the clinical long-term efficacy and safety of endoscopic resection for large(≥ 3 cm) gastric stromal tumors.METHODS All patients who underwent endoscopic resection or surgery at our hospital from 2012 to 2017 for pathologically confirmed gastric stromal tumor with a maximum diameter of ≥ 3 cm were collected. The clinical data, histopathologic characteristics of the tumors, and long-term outcomes were recorded.RESULTS A total of 261 patients were included, including 37 patients in the endoscopy group and 224 patients in the surgical group. In the endoscopy group, the maximum tumor diameter was 3-8 cm; the male: Female ratio was 21/16; 34 cases had low-risk tumors, 3 had intermediate-risk, and 0 had high-risk; the mean follow-up time was 30.29 ± 19.67 mo, no patient was lost to follow-up, and no patient received chemotherapy after operation; two patients with recurrence had low-risk stromal tumors, and neither had complete resection under endoscopy. In the surgical group, the maximum tumor diameter was 3-22 cm; the male: Female ratio was 121/103; 103 cases had low-risk tumors, 75 had intermediate-risk, and 46 had high-risk; the average follow-up time was 38.83 ± 21.50 mo, 53 patients were lost to follow-up, and 8 patients had recurrence after operation(6 cases had high-risk tumors, 1 had intermediate-risk, and 1 had low-risk). The average tumor volume of the endoscopy group was 26.67 ± 26.22 cm^3(3.75-120), all of which were less than 125 cm^3. The average volume of the surgical group was 273.03 ± 609.74 cm^3(7-4114). Among all patients with a tumor volume < 125 cm^3,7 with high-risk stromal tumors in the surgical group(37.625 cm^3 to 115.2 cm^3)accounted for 3.8%(7/183); of those with a tumor volume < 125 cm^3, high-risk patients accounted for 50%(39/78). We found that 57.1%(12/22) of patients with high-risk stromal tumors also had endoscopic surface ulcer bleeding and tumor liquefaction on ultrasound or abdominal computed tomography; the ratio of tumors positive for both in high-risk stromal tumors with a volume < 125 cm^3 was 60%(3/5).CONCLUSION Endoscopic treatment is safe for 95.5% of patients with gastric stromal tumors with a tumor diameter ≥ 3 cm and a volume of < 125 cm^3 without endoscopic surface ulcer bleeding or CT liquefaction. | Yuan-Yuan Xiang Yuan-Yuan Li Ling Ye Yin Zhu Xiao-Jiang Zhou You-Xiang Chen Guo-Hua Li | 2019 | World Journal of Clinical Cases2019，7，7： | 6 |
| 7 | 胃间质瘤不同解剖部位对腹腔镜手术疗效的影响显示文摘目的:探讨胃间质瘤不同解剖部位对腹腔镜手术疗效的影响。方法:纳入2011年12月至2013年12月收治的120例胃间质瘤患者作为研究对象,均行腹腔镜手术。按胃不同解剖部位,分为观察组与对照组,观察组(n=78)肿瘤位于解剖有利部位,即胃底部及胃前壁、大弯侧,对照组(n=42)肿瘤处于解剖困难部位,即胃食管结合部、胃小弯侧及后壁、胃窦、幽门。对比两组围术期基本指标、术后并发症及随访结果,如手术时间、术中出血量及术后胃管拔除时间、首次排气时间、首次饮食时间、腹腔引流管拔除时间、住院时间。结果:两组术中出血量及术后胃管拔除时间、首次排气时间、首次饮食时间、腹腔引流管拔除时间、住院时间差异均无统计学意义(P>0.05);观察组手术时间短于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率为8.97%,对照组为7.14%,差异无统计学意义(P>0.05)。术后均获随访,观察组局部复发率为19.23%,对照组为16.67%,差异无统计学意义(P>0.05);观察组生存率为93.59%,对照组为92.86%,差异亦无统计学意义(P>0.05)。结论:与解剖有利部位相比,解剖困难部位的胃间质瘤行腹腔镜手术,虽然手术时间稍长,但近、远期疗效并无明显变化。对于解剖位置较困难的胃间质瘤,行腹腔镜切除是有效可行的。 | 冯涛 | 2019 | 腹腔镜外科杂志2019，24，2： | 5 |
| 8 | Endoscopic full thickness resection for gastric tumors originating from muscularis propria显示文摘AIM: To do systematic review of current literature for endoscopic full thickness resection(EFTR) technique for gastric tumors originating from muscularis propria.METHODS: An extensive English literature search was done till December 2015; using Pub Med and Google scholar to identify the peer reviewed original and review articles using keywords-EFTR, gastric tumor, muscularis propria. Human only studies were included. The references of pertinent studies were manually searched to identify additional relevant studies. The indications, procedural details, success rates, clinical outcomes, complications and limitations were considered. For the purpose of review, data from individual studies was combined to calculate mean. No other statistical test was applied.RESULTS: A total of 9 original articles were identified. Four articles were from same institute and the time frames of these studies were overlapping. To avoid duplication of data, only the study with patients over the longest time interval was included and other three were excluded. In total six studies were included in the final review. In our systematic review, the mean success rate for EFTR of gastric tumors originating from muscularis propria was 96.8%. The mean procedure time varied from a minimum of 37 min to a maximum of 105 min. There was no reported mortality from the technique itself. The most common histological diagnosis was gastrointestinal stromal tumors and leiomyoma. Gastric wall defect closure by either metallic clips or over the scope clip(OTSC) had similar outcomes although experience with OTSC was limited to smaller lesions(<3cm).CONCLUSION: EFTR is a minimally invasive technique to resect gastric submucosal tumors originating from muscularis propria with a high success rate and low complication rate. | Deepanshu Jain Ejaz Mahmood Aakash Desai Shashideep Singhal | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，14： | 4 |
| 9 | 常见消化道黏膜下肿物的内镜诊断及治疗显示文摘消化道黏膜下肿物(SMTs)目前在临床上较为常见,但以往由于常规的内镜下活检只能钳取到浅表黏膜层,对于起源于黏膜下层及固有肌层的肿物,其病理常难以获得,多随访观察,出现临床症状才给予外科手术治疗。随着消化内镜技术的发展及病理学检测技术的深入,常能获取完整理想的病理样本,而且将多种内镜技术应用于SMTs的切除也成为可能。内镜下微创治疗技术逐渐脱颖而出,成为治疗SMTs的新技术,因其具有微创、有效、安全、可行等优点,现已成为研究热点。 | 张安楠 徐洪雨 | 2017 | 医学综述2017，23，7： | 3 |
| 10 | Closure techniques in exposed endoscopic full-thickness resection:Overview and future perspectives in the endoscopic suturing era显示文摘Exposed endoscopic full-thickness resection(EFTR)without laparoscopic assistance is a minimally invasive natural orifice transluminal endoscopic surgery technique that is emerging as a promising effective and safe alternative to surgery for the treatment of muscularis propria-originating gastric submucosal tumors.To date,various techniques have been used for the closure of the transmural postEFTR defect,mainly consisting in clip-and endoloop-assisted closure methods.However,the recent advent of dedicated tools capable of providing full-thickness defect suture could further improve the efficacy and safety of the exposed EFTR procedure.The aim of our review was to evaluate the efficacy and safety of the different closure methods adopted in gastric-exposed EFTR without laparoscopic assistance,also considering the recent advent of flexible endoscopic suturing. | Antonino Granata Alberto Martino Dario Ligresti Francesco Paolo Zito Michele Amata Giovanni Lombardi Mario Traina | 2021 | World Journal of Gastrointestinal Surgery2021，13，7： | 2 |
| 11 | Endoscopic or laparoscopic resection for small gastrointestinal stromal tumors: a cumulative meta-analysis显示文摘Background:Despite the recent large number of studies comparing endoscopic and laparoscopic resection for small gastrointestinal stromal tumors(GISTs)(diameter≤5 cm),the results remain conflicting.The objective of this work was to perform a cumulative meta-analysis to assess the advantages and disadvantages of endoscopic resection vs.laparoscopic resection.Methods:The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.We searched medical databases up to January 2020.Meta-analytical random or fixed effects models were used in pooled analyses.Meta-regression,cumulative meta-analyses,and sub-group analyses were performed to improve the accuracy of the conclusion.Sensitivity analyses were applied to assess the robustness of the results.Results:A total of 12 cohort studies with 1383 participants comparing endoscopic resection and laparoscopic resection were identified,while three cohort studies with 167 participants comparing endoscopic resection and laparoscopic and endoscopic cooperative surgery were found.We found that endoscopic resection had shorter operation times(weighted mean difference[WMD]=-27.1 min,95%confidence interval[CI]:-40.8 to-13.4 min)and lengths of hospital stay(WMD=-1.43 days,95%CI:-2.31 to-0.56 days)than did laparoscopic resection.The results were stable and reliable.There were no significant differences in terms of blood loss,hospitalization costs,incidence of complications or recurrence rates.For tumor sizes 2 to 5 cm,endoscopic resection increased the risk of positive margins(relative risk[RR]=5.78,95%CI:1.31-25.46).Although operation times for endoscopic resection were shorter than those of laparoscopic and endoscopic cooperative surgery(WMD=-41.03 min,95%CI:-59.53 to-22.54 min),there was a higher incidence of complications(RR=4.03,95%CI:1.57-10.34).Conclusions:In general,endoscopic resection is an alternative method for gastric GISTs≤5 cm.Laparoscopic and endoscopic cooperative surgery may work well in combination.Further randomized controlled trials are recommended to validate or update these results. | Xian-Lei Cai Xue-Ying Li Chao Liang Yuan Xu Miao-Zun Zhang Wei-Ming Yu Xiu-Yang Li | 2020 | Chinese Medical Journal2020，，22： | 1 |
| 12 | Screening for Differentially Expressed Genes of Gastric Stromal Tumor Originating from Muscularis Propria显示文摘 | Ju Huang Bo Zhang Liu-Ye Huang | 2017 | Chinese Medical Journal2017，，6： | 1 |
| 13 | 腹腔镜手术治疗困难解剖位置胃间质瘤患者的临床疗效分析显示文摘目的探讨腹腔镜手术对困难解剖位置胃间质瘤的临床治疗效果。方法选取2013年1月~2017年12月我院收治的瘤体位置在胃食管结合部、胃小弯侧及后壁、胃窦、幽门等困难解剖位置的胃间质瘤患者150例,根据手术方式不同分为观察组72例和对照组78例。观察组行腹腔镜下胃间质瘤切除术,对照组行开腹胃间质瘤切除术,观察两组手术相关数据、术后恢复指标及远期预后。结果观察组手术时间、术中出血量、术后胃肠功能恢复时间、住院时间均明显低于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05);观察组肿瘤复发率、远期疗效与对照组比较差异无统计学意义(P>0.05)。结论对于解剖位置在困难部位的胃间质瘤患者,行腹腔镜手术切除具有可靠的治疗效果和安全性,且比开腹手术创伤小、并发症少,更能加快患者术后恢复。 | 柴素伟 | 2019 | 现代诊断与治疗2019，0，17： | 0 |
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