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[小肠神经内分泌肿瘤的外科治疗方面]

[Surgical aspects of neuroendocrine tumors of the small intestine].

作者信息

Weber F, Dralle H

机构信息

Sektion Endokrine Chirurgie, Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Hufelandstraße 55, 45127, Essen, Deutschland.

出版信息

Chirurg. 2018 Jun;89(6):428-433. doi: 10.1007/s00104-018-0607-4.

Abstract

Neuroendocrine tumors of the small intestines are a rare disease with an incidence of 1 per 100,000 of the population; however, they account for over 20% of all neuroendocrine tumors and are the most common malignancy of the small intestines. Diagnosis is often made at a late stage of the disease, as the clinical symptoms are unspecific. Approximately one third of all patients show hepatic metastases at the time of diagnosis. There is no correlation between tumor size and tumor stage. Even small tumors <10 mm harbor the risk for lymphatic and distant metastases so that the extent of surgery is not determined by the size of the primary tumor. The intestinal-sparing resection with systematic lymphadenectomy along the superior mesenteric artery and removal of the retropancreatic lymph nodes is recommended even in localized stages of the disease.

摘要

小肠神经内分泌肿瘤是一种罕见疾病,发病率为每10万人中有1例;然而,它们占所有神经内分泌肿瘤的20%以上,是小肠最常见的恶性肿瘤。由于临床症状不具特异性,诊断通常在疾病晚期作出。所有患者中约三分之一在诊断时出现肝转移。肿瘤大小与肿瘤分期之间没有相关性。即使是小于10毫米的小肿瘤也有发生淋巴转移和远处转移的风险,因此手术范围不由原发肿瘤大小决定。即使在疾病的局部阶段,也建议行保留肠管的切除术,并沿肠系膜上动脉进行系统性淋巴结清扫以及切除胰后淋巴结。

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