目的：由于担心术中肿瘤破裂，腹腔镜手术治疗>5 cm胃GIST仍存争议。方法：为探讨腹腔镜手术切除>5 cm胃GIST的可行性及安全性，我们于2011年3月至2015年3月入组一前瞻性研究队列。研究主要终点为术中肿瘤破裂发生率；次要终点包括：中转开腹率、手术时间、手术出血量、恢复流食及固体食物时间、术后住院时间及随访期间肿瘤复发率。结果：共有22例患者进入研究队列，平均肿瘤直径(7.04±1.53)cm，范围：(5.2~10.8cm)，无术中肿瘤破裂。平均手术时间(88.1±31.9)min，估计手术出血量(37.1±18.7)mL，无需输血病例。恢复流食及固体食物时间分别为(1.1±0.6)d及(2.5±0.9)d。平均术后住院时间为(5.4±5.8)d。平均随访时间为(18.9±10.2)月，范围：(2~47月)，随访期内无复发病例。结论：腹腔镜手术切除>5 cm胃GIST安全、可行。
Is it feasible and safe for laparoscopic resection for gastric GIST larger than 5 cm? Result from a prospective cohort study
Objective: Role of laparoscopic resection for large (especially larger than 5 cm) gastric GIST is still in debate for the fear of intraoperative tumor rupture. Methods: To determine the feasibility and safety of laparoscopic approach in treatment of large gastric GIST, a prospective study was carried out between March 2011 and March 2015. Intraoperative tumor rupture was studied as primary outcome. Secondly outcomes were conversion rate, operating time, estimated blood loss, time of tolerate fluid and solid diet, length of postoperative hospital stay and recurrence rate at the end of the follow-up. Results: Twenty-two patients were included in this study with tumor size (7.04 ty-tw) cm (range, 5.2~10.8 cm). No intraoperative tumor rupture occurred. The median duration of operation was (88.1±31.9) min with estimated blood loss (37.1±18.7) mL. No patient needed blood transfusion. The average time until start of oral intake for fluid and solid diet was (1.1±0.6) days and (2.5±0.9) days, respectively. The median time for length of postoperative hospital stay was (5.4±5.8) days. The follow-up period for all the patients was (18.9follo) months (range, 2~47months). No local or distant recurrence was observed. Conclusion: Laparoscopic resection for large gastric GIST is feasible and safe. Laparoscopic surgery should be considered as standard approach in all cases irrespective of tumor size and location.