部分腹部内脏切除和肠自体移植以切除肠系膜类癌肿瘤。
Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor.
机构信息
Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
出版信息
World J Surg Oncol. 2011 Jan 31;9:11. doi: 10.1186/1477-7819-9-11.
BACKGROUND
Midgut carcinoids are neuroendocrine tumors that commonly metastasize to the intestinal mesentery, where they predispose to intestinal obstruction, ischemia and/or congestion. Because of their location, many mesenteric carcinoid tumors are deemed unresectable due to the risk of uncontrollable bleeding and prolonged intestinal ischemia.
CASE PRESENTATION
We report the case of a 60-year-old male with a mesenteric carcinoid tumor obstructing his superior mesenteric vein, resulting in intestinal varices and severe recurrent GI bleeds. While his tumor was thought to be unresectable by conventional techniques, it was successfully resected using intestinal autotransplantation to safely gain access to the tumor. This case is the first described application of this technique to carcinoid tumors.
CONCLUSIONS
Intestinal autotransplantation can be utilized to safely resect mesenteric carcinoid tumors from patients who were not previously thought to be surgical candidates. We review the literature concerning both carcinoid metastases to the intestinal mesentery and the use of intestinal autotransplantation to treat lesions involving the mesenteric root.
背景
类癌是一种常见转移至肠系膜的神经内分泌肿瘤，易导致肠梗阻、肠缺血和/或肠淤血。由于其位置，许多肠系膜类癌肿瘤由于不可控出血和延长肠缺血的风险而被认为无法切除。
病例介绍
我们报告了一例 60 岁男性的病例，他患有肠系膜类癌肿瘤，阻塞了肠系膜上静脉，导致肠静脉曲张和严重的复发性胃肠道出血。虽然他的肿瘤被认为无法通过传统技术切除，但通过肠自体移植成功切除了肿瘤，从而安全地接近肿瘤。这是首例应用该技术治疗类癌肿瘤的病例。
结论
肠自体移植可用于安全切除肠系膜类癌肿瘤，即使这些患者以前被认为不适合手术。我们回顾了有关类癌转移至肠系膜和使用肠自体移植治疗涉及肠系膜根部病变的文献。
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