| 摘要: |
| 目的 探讨十二指肠胃肠道间质瘤（GIST）局部切除手术和消化道重建方式，并总结临床经验。方法 收集2010年1月至2018年1月于我院肛肠外科接受局部切除治疗的29例十二指肠GIST患者的临床资料。分析患者局部切除手术和消化道重建方式，并结合临床病理参数及随访资料探讨不同术式的临床疗效和适用范围。结果 29例十二指肠GIST患者中，24例（82.8%）位于十二指肠球部和降部，5例（17.2%）位于水平部和升部。19例行单纯楔形切除+一期吻合（16例开腹手术、3例腹腔镜手术），7例行开腹区段切除术+毕Ⅱ式胃空肠吻合+Roux-en-Y式吻合，2例行开腹楔形切除术+Roux-en-Y式十二指肠空肠吻合，1例行开腹区段切除术+侧-侧十二指肠空肠吻合。术后病理示所有患者肿瘤切缘均为阴性（R0）。术后发生吻合口瘘2例，肠梗阻3例。随访期间所有患者均无局部复发。结论 局部切除手术是治疗十二指肠GIST的合理选择之一，疗效可靠。 |
| 关键词: 胃肠道间质肿瘤 十二指肠 手术切除 消化道重建 存活率 |
| DOI：10.16781/j.0258-879x.2019.08.0919 |
| 投稿时间：2019-02-24修订日期：2019-03-29 |
| 基金项目: |
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| Local resection of duodenal gastrointestinal stromal tumors: a clinical experience of 29 cases |
| SUN Qiang,LI Xin-xing,WEI Shu-xun,CHEN Jin-shui,HU Zhi-qian,WANG Wei-jun* |
(Department of Anorectal Surgery, Changzheng Hospital, Naval Medical University(Second Military Medical University), Shanghai 200003, China
*Corresponding author) |
| Abstract: |
| Objective To explore local surgical excision of duodenal gastrointestinal stromal tumor (GIST) and the way of digestive tract reconstruction, and to summarize our clinical experience. Methods The clinical data of 29 patients with duodenal GIST who underwent local resection from Jan. 2010 to Jan. 2018 in the Department of Anorectal Surgery of our hospital were included for study. The local resection methods and the reconstruction of digestive tract were analyzed, and the clinical efficacy and indications of different local resection methods were discussed while considering the clinicopathological parameters and follow-up data. Results We found that 24 (82.8%) cases had their lesions located in the bulb and descending part of the duodenum and 5 (17.2%) cases in the horizontal and ascending part of the duodenum. Nineteen cases underwent simple wedge resection and one-stage anastomosis (16 cases underwent open surgery and 3 cases underwent laparoscopic surgery), 7 cases underwent open segment resection+Billroth Ⅱ gastrojejunostomy+Roux-en-Y anastomosis, 2 cases underwent open wedge resection+Roux-en-Y duodenojejunostomy, and 1 case underwent open segment resection+duodenojejunostomy lateral anastomosis. Postoperative pathology showed that all patients had negative resection margin (R0). Anastomotic fistula occurred in 2 cases and intestinal obstruction in 3 cases. No local recurrence was noticed during the follow-up. Conclusion Local excision is a reasonable choice for duodenal GIST, with reliable curative effect. |
| Key words: gastrointestinal stromal tumors duodenum surgical resection digestive tract reconstruction survival rate |
