腹腔镜胃癌根治性切除术后穿刺孔种植转移瘤的外科治疗  

Surgical treatment of port-site metastases after laparoscopic radical resection of gastric cancer

作　　者：施永康 牟一平[1] 王元宇[1] 钱振渊[1] 金巍巍[1] 姚海波[1] 赵忠扩[1] 许晓东[1] 邵钦树[1] Shi Yongkang;Mou Yiping;Wang Yuanyu;Qian Zhenyuan;Jin Weiwei;Yao Haibo;Zhao Zhongkuo;Xu Xiaodong;Shao Qinshu(Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People′s Hospital, People′s Hospital of Hangzhou Medical College, and Key Laboratory of Gastroenterology of Zhejiang Province, Hangzhou 310014, China)

机构地区：[1]浙江省人民医院胃肠胰外科,杭州医学院附属人民医院胃肠胰外科,浙江省胃肠病重点实验室,杭州310014

出　　处：《中华医学杂志》2019年第32期2497-2500,共4页National Medical Journal of China

基　　金：浙江省自然科学基金(LY15H160030).

摘　　要：目的探讨腹腔镜胃癌根治性切除术后穿刺孔种植转移瘤的外科治疗效果。方法回顾性总结分析2014年1月至2018年1月浙江省人民医院收治的5例腹腔镜胃癌根治性切除术后穿刺孔种植转移患者资料和随访资料。结果3例腹壁穿刺孔种植转移瘤出现在术后6个月(含6个月),1例出现在术后10个月,1例出现在术后30个月。排除腹腔及远处转移,5例穿刺孔种植转移瘤患者均行手术切除,术后恢复良好,无切口感染和切口疝发生。随访截止时,2例已死亡,分别生存13和24个月;3例仍健在,随访最短7个月,最长19个月。结论穿刺孔种植转移瘤位置表浅,手术切除肿瘤并不困难,对于无腹腔内和远处复发转移的患者,行手术治疗能提高患者的预后。Objective To investigate the feasibility of surgical treatment of port-site metastasis after laparoscopic radical resection of gastric cancer. Methods The clinical and follow-up data of five patients with port-site metastases after laparoscopic radical resection of gastric cancer at Zhejiang Provincial People′s Hospital between January 2014 and January 2018 were retrospectively analyzed. Results Port-site metastases occurred within 6 months after gastrointestinal tumor resection in three patients, 10 months after the operation in one patient, and 30 months after the operation in one patient, respectively. Metastasis to the abdominal cavity or distant metastasis was excluded before the surgical treatment of the port-site metastases, and all patients recovered well after the operation. No incisional infection or hernia occurred. By December 2018, two patients died (they survived for 13 and 24 months, respectively) and three patients survived. The follow-up duration ranged from 7 to 19 months. Conclusions Surgical resection of port-site metastases is not difficult due to their superficial location. Surgical treatment can improve the prognosis of patients without abdominal or distant metastasis/recurrence.

关 键 词：胃癌 腹腔镜 穿刺孔 种植转移 治疗 

分 类 号：R735.2[医药卫生—肿瘤]