胃间质瘤的外科治疗(附40例报告)  

Surgical Treatment of Gastric Stromal Tumor(with a Report of 40 Cases)

作　　者：杨春康[1] 李樟寿[1] 戴起宝[1] 张惠灏[1] 郑炜[1] 

机构地区：[1]福建医科大学附属第一医院肿瘤外科

出　　处：《中国现代手术学杂志》2005年第3期186-188,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨胃间质瘤的诊治方法。方法回顾性分析40例胃间质瘤的临床表现、诊断和外科治疗。结果40例中最主要的临床症状为上腹部胀痛不适,经胃镜、胃肠钡透、CT及B超等检查发现,29例肿瘤位于贲门及胃底体部,11例位于胃窦部。40例均经手术切除,切除率为100%,14例(35.0%)行肿瘤单纯切除,11例(27.5%)行远端胃大部切除术,14例(35.0%)行胃近端切除,1例(2.5%)行全胃切除及胰尾和脾切除术。本组均获随访,平均3.5年,7例复发(17.5%),再次行肿瘤单纯切除术或含大网膜的肿瘤切除;4例死亡(10%),均为恶性患者。结论胃间质瘤治疗以手术为主,根据肿瘤部位、大小及病理结果选择不同术式,切缘至少距肿瘤3cm以上,不需常规行淋巴结清扫,术中保证肿瘤的完整性十分重要。Objective To investigate the diagnostic and therapeutic method of gastric stromal tumor(GST). Method 40 cases of GST were retrospectively reviewed with regard to clinical manifestation, diagnosis and treatment. Result All cases major manifested as upper abdominal discomfort, tumor were found by gastroscopy, barium meal, computed tomography, and B ultrasonography which located at cardia, gastric fundus and body in 29 cases and gastric antrum in 11 cases. All cases underwent resection, of which wedge resection in 14 cases (35.0%), distal subtotal gastrectomy in 11 cases (27.5%), proximal gastrectomy in 14 cases (35.0%), total gastrectomy combined with pancreatic tail resection and splenectomy in 1 case (2.5%). All cases were followed up with average duration of 3.5 years, showed 7 cases of recurrence which underwent subsequent resection, 4 death occurred which were the malignant cases. Conclusion Surgical approach remains the major treatment for GIST, the operation should be designed according to tumor location, tumor size and pathological findings, the surgical margin should be kept a distance of least 3 cm from tumor, no routine lymphatic clearance be requested whereas en-bloc resection should be ensured.

关 键 词：胃肿瘤 胃间质瘤 外科手术 GST 化疗 

分 类 号：R735.2[医药卫生—肿瘤]