摘要
胃肠道间质瘤（GIST）可以发生于胃肠道、网膜、肠系膜或腹膜表面，其中约60％发生于胃。GIST的手术治疗原则是尽量完整切除病灶。对于转移复发的GIST，手术仅限于解决穿孑L、梗阻、出血等并发症。绝大部分胃间质瘤可以局部或楔形切除。位于贲门周围的间质瘤，如果局部切除后可能造成贲门狭窄，可以采取近端胃切除。胃窦小弯侧的间质瘤可以酌情进行远端胃切除，胃间质瘤患者极少实施全胃切除。发生于胃体大弯侧的问质瘤常需要联合脾、胰尾、横结肠切除。十二指肠间质瘤尽量采取局部切除，有经验的中心可以行胰十二指肠切除术。小肠问质瘤手术操作时避免肿瘤破裂，一旦发现肿瘤侵犯周围脏器、结构，应该果断采取联合脏器切除。直肠间质瘤原则上采取低位前切除，避免腹会阴联合手术。
Gastrointestinal stromal tumor （GIST） arises from gastrointestinal tract, omentum, mesentery or peritoneal surface. Of which, about 60% arises from stomach. The principle of surgical treatment is removing the tumor as completely as possible. The indications of operation for metastatic and recurrent GIST are perforation, obstruction and hemorrhage. The majority of gastric stromal tumor can be removed with local or wedge excision. Proximal gastrectomy is a choice for GIST locating at the cardia since local resection may cause cardia steno- sis. Distal gastrectomy is suitable for GIST locating at lesser curvature of gastric antrum. Total gastrectomy is not a common procedure for gastric stromal tumor. Combined spleen, tail of pan- creas and transverse colon resection may necessary for R0 surgery. Local resection is the first choice for duodenal stromal tumor, pancreaticoduodenectomy can be performed in large medical center. Operative procedure must be carefully carried out for small intestinal stromal tumor to avoid tumor rupture. Combined resection is a right choice when tumor involved surrounding organs or structures. In principle, low anterior instead of abdominoperineal resection is the only recommend procedure for rectal stromal tumor.
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2013年第4期249-252,共4页
Chinese Journal of Digestive Surgery
关键词
胃肠道间质肿瘤
外科手术
Gastrointestinal stromal neoplasms
Surgical procedure, operative
