Tomoda H, Furusawa M, Hayashi I
Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
Jpn J Surg. 1989 Sep;19(5):544-8. doi: 10.1007/BF02471661.
In this report, we discuss the current policy of surgery for small carcinoid tumors of the rectum, with reference to our own cases and also to those reported in the literature. Ten cases of rectal carcinoid tumors were surgically treated at the National Kyushu Cancer Center over a period of sixteen years and three months. The tumors ranged in size from 0.2 to 1.0 cm, with an average of 0.5 cm, and all were confined to the submucosa. The lesions were treated by local excision in eight patients and by low anterior resection in the other two cases, where transanal or transsacral excision was considered difficult. No lymph node involvement was found in these two cases. All patients are alive and well without recurrence, after an average follow-up time of three years and six months. According to the literature, the incidence of metastasis from rectal carcinoid tumors smaller than 1 cm is very low, ranging between 1.7 to 3.4 per cent, and it therefore seems that most such lesions can be treated by local excision alone. If, however, any muscle invasion or lymphatic vessel invasion is demonstrated, then radical surgery is recommended.
在本报告中，我们结合自身病例以及文献报道，探讨了目前直肠小类癌肿瘤的手术治疗策略。在十六年零三个月的时间里，九州国立癌症中心对10例直肠类癌肿瘤患者进行了手术治疗。肿瘤大小从0.2厘米至1.0厘米不等，平均为0.5厘米，且均局限于黏膜下层。8例患者采用局部切除治疗，另外2例因经肛门或经骶骨切除困难，行低位前切除术。这2例均未发现淋巴结受累。所有患者在平均三年零六个月的随访期后均存活且无复发。根据文献，直径小于1厘米的直肠类癌肿瘤转移发生率非常低，在1.7%至3.4%之间，因此似乎大多数此类病变仅通过局部切除即可治疗。然而，如果证实存在任何肌层浸润或淋巴管浸润，则建议行根治性手术。
