十二指肠节段切除术治疗十二指肠胃肠道间质瘤。
Segmental duodenectomy for gastrointestinal stromal tumor of the duodenum.
机构信息
Department of Surgery, University Hospital Geneva, 24 rue Micheli-du-Crest, 1211, Geneva, Switzerland.
出版信息
World J Gastroenterol. 2010 Jun 14;16(22):2788-92. doi: 10.3748/wjg.v16.i22.2788.
AIM
To evaluate the results of segmental duodenectomy (SD) and pancreaticoduodenectomy (PD) for duodenal gastrointestinal stromal tumor (GIST) and help clinicians with surgical management.
METHODS
All patients who underwent surgery for non-metastatic GIST of the duodenum in a single institution since 2000 were prospectively followed up. Seven patients (median age 51 years, range: 41-73 years) were enrolled: five underwent SD and two underwent PD.
RESULTS
All the patients had a complete resection (R0), with no postoperative morbidity and mortality. Among the SD group, GIST was classified as low risk in two patients, intermediate risk in two, and high risk in one, according to the Fletcher scale, (vs two high risk patients in the PD group). With a median follow-up of 41 (18-85) mo, disease-free survival (DFS) rates were 100% after SD and 0% after PD (P < 0.05). The median DFS was 13 mo in the PD group.
CONCLUSION
Whenever associated with clear surgical margins, SD is a reliable and curative option for most duodenal GISTs, and is compatible with long-term DFS.
目的
评估十二指肠节段切除术（SD）和胰十二指肠切除术（PD）治疗十二指肠胃肠道间质瘤（GIST）的效果，为临床医生的手术治疗提供帮助。
方法
自 2000 年以来，单中心前瞻性随访所有接受手术治疗的非转移性十二指肠 GIST 患者。共纳入 7 例患者（中位年龄 51 岁，范围：41-73 岁）：5 例行 SD，2 例行 PD。
结果
所有患者均行完整切除（R0），无术后并发症和死亡。根据 Fletcher 量表，SD 组中 2 例患者为低危，2 例为中危，1 例为高危，（而 PD 组中有 2 例为高危）。中位随访 41（18-85）个月后，SD 组的无疾病生存率（DFS）为 100%，而 PD 组为 0%（P<0.05）。PD 组的中位 DFS 为 13 个月。
结论
只要与明确的手术切缘相关，SD 是治疗大多数十二指肠 GIST 的可靠且可治愈的选择，且与长期 DFS 兼容。
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