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肠系膜肿瘤:诊断与治疗。

Mesenteric tumors: diagnosis and treatment.

机构信息

Service de Chirurgie Digestive, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.

出版信息

J Visc Surg. 2012 Aug;149(4):e239-51. doi: 10.1016/j.jviscsurg.2012.05.005. Epub 2012 Jul 15.

Abstract

Mesenteric tumors are rare and consist of a heterogeneous group of lesions. Masses may arise from any of the mesenteric components: peritoneum, lymphatic tissue, fat, and connective tissue. Cellular proliferation can also arise from infectious or inflammatory processes. They can be classified as solid or cystic, benign or malignant. Mesenteric tumors are usually discovered incidentally or during investigation of non-specific symptoms. While clinical examination and imagery may suffice to make the diagnosis, histopathology is often required by either needle percutaneous or surgical biopsy, or immediate excision. Therapeutic management options vary widely depending on the nature of the lesion; they range from simple observation or medical therapy to surgery. Benign well-delineated mesenteric masses that are symptomatic can often be treated by simple enucleation. But invasive malignant tumors require a carcinologic resection; a careful preoperative evaluation to assess the relationship between the mass and adjacent vascular and digestive structures is essential since they may dictate the need for extensive sacrifice of bowel with resultant intestinal insufficiency due to short bowel syndrome.

摘要

肠系膜肿瘤较为罕见,由多种病变组成。肿块可源自肠系膜的任何组成部分:腹膜、淋巴组织、脂肪和结缔组织。细胞增殖也可能由感染或炎症过程引起。它们可以分为实性或囊性、良性或恶性。肠系膜肿瘤通常是偶然发现的,或者是在非特异性症状的检查过程中发现的。虽然临床检查和影像学检查可能足以做出诊断,但通常需要通过经皮或手术活检,或立即切除进行组织病理学检查。治疗管理方案因病变性质而异;它们范围从简单的观察或药物治疗到手术。良性、边界清楚的肠系膜肿块如果有症状,通常可以通过简单的剜除术治疗。但是侵袭性恶性肿瘤需要进行肿瘤学切除;术前仔细评估肿块与邻近血管和消化结构的关系至关重要,因为这可能需要广泛切除肠道,导致短肠综合征引起的肠道功能不全。

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