体外切除及小肠自体移植治疗肠系膜根部肿瘤
Ex-vivo Resection and Small-Bowel Auto-transplantation for the Treatment of Tumors at the Root of the Mesentery.
作者信息
Nikeghbalian S, Aliakbarian M, Kazemi K, Shamsaeefar A R, Mehdi S H, Bahreini A, Malek-Hosseini S A
机构信息
Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran ; Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
Int J Organ Transplant Med. 2014;5(3):120-4.
BACKGROUND
Tumors involving the root of the mesentery are generally regarded as "unresectable" with conventional surgical techniques. Resection with conventional surgery may end in life-threatening complications in these patients. Ex-vivo resection and auto-transplantation avoids excessive bleeding and prevents ischemic related damage to the small intestine and other organs.
OBJECTIVE
To share our experience of ex-vivo resection of the tumors with involvement of small bowel mesentery followed by small bowel auto-transplantation.
METHODS
In this study, medical records of all the patients who underwent ex-vivo resection and auto-transplantation at our center were retrospectively analyzed.
RESULTS
The most common indication for the procedure in our series was locally advanced pancreatic carcinoma. Our survival rate was 50% with a mean±SD follow-up of 10.1±9.8 (range: 0-26) months. Causes of early in-hospital mortality were multi-organ failure, sepsis, and cerebrovascular accident. Recurrence of disease was noted in one patient while one patient developed hepatic metastasis after 20 months of surgery.
CONCLUSION
Ex-vivo resection of the tumor and auto-transplantation is the surgical treatment of choice for the locally advanced abdominal tumors involving the root of the mesentery.
背景
累及肠系膜根部的肿瘤通常被认为采用传统手术技术“无法切除”。对这些患者进行传统手术切除可能会导致危及生命的并发症。体外切除和自体移植可避免大量出血，并防止小肠和其他器官发生缺血相关损伤。
目的
分享我们对累及小肠系膜的肿瘤进行体外切除并随后进行小肠自体移植的经验。
方法
在本研究中，对在我们中心接受体外切除和自体移植的所有患者的病历进行了回顾性分析。
结果
在我们的系列病例中，该手术最常见的适应证是局部晚期胰腺癌。我们的生存率为50%，平均±标准差随访时间为10.1±9.8（范围：0 - 26）个月。早期院内死亡原因是多器官功能衰竭、脓毒症和脑血管意外。1例患者出现疾病复发，1例患者在手术后20个月发生肝转移。
结论
肿瘤体外切除和自体移植是治疗累及肠系膜根部的局部晚期腹部肿瘤的手术首选方法。
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