摘要
目的探讨十二指肠间质瘤的临床特征、外科治疗方法及效果。方法回顾性分析复旦大学附属中山医院1995—2004年间收治的18例十二指肠间质瘤患者的临床资料。结果本组患者临床表现为黑便者7例，腹痛6例，饱胀5例，贫血3例。分别经上消化道钡餐造影、胃镜、内镜超声及CT诊断，肿瘤位于十二指肠降部13例，水平部2例，球部2例，升部1例；肿瘤直径2．0—9．O（平均4．8）cM。肿瘤恶性15例（83．3％），交界性2例（11．1％），良性1例（5．6％）；梭形细胞型14例，混合型3例，上皮细胞型1例。9例十二指肠降部肿瘤者行胰十二指肠切除术，术后病理检查均无淋巴结转移；4例十二指肠降部和1例球部肿瘤者行肿瘤及十二指肠壁局部切除术：2例十二指肠水平部和1例升部肿瘤者行十二指肠节段切除术；另有1例十二指肠球部肿瘤者行胃远端大部切除术。15例术后获得17个月至8年的随访，1、3年生存率分别为100％和86．7％。结论十二指肠间质瘤恶性多见。手术治疗为主，手术方式的选择取决于肿瘤的位置和大小。
Objective To investigate the clinical characteristics,surgical procedures and prognosis of duodenal gastrointestinal stromal tumors（GISTs）. Methods The clinical data of 18 GIST patients, collected from 1995 to 2004, were retrospectively analyzed. Results The lesions of duodenal GISTs mainly located in the descending duodenum （13/18）, unusually in the horizontal part （2/18）, ascending part （1/18）, and the bulb （2/18）. Pathological examination revealed 1 ease of benign tumor, 2 eases of borderline tumors and 15 eases of malignant tumors, Microscopically, the tumors were composed of spindle cells （14 eases）, epithelial cell （1 ease）, and mixed eell types （3 eases）. The clinical manifestations were non-specific, mostly was melena （7/18）, as well as abdominal pain （6/18）, fullness （5/18）, and anemia （3/18）. The diagnoses were performed by upper gastrointestinal radiography, gastroseopy, endoscopic ultrasonography and CT scan. All of the 18 patients received surgical treatment, including 9 panereatieoduodeneetomies, 5 local resections, 3 segmental resections of duodenum, and 1 distal subtotal gastreetomy. 1 and 3 year survival rates were 100% and 86.7% respectively. Conclusion Most duodenal GISTs are malignant, and the choices of surgical procedures are mainly determined by the location and size of the tumors.
出处
《中华胃肠外科杂志》
CAS
2007年第1期26-28,共3页
Chinese Journal of Gastrointestinal Surgery
关键词
十二指肠
胃肠间质瘤
外科手术
Duodenum
Gastrointestinal stromal tumor
Surgical procedure, operatives
