腹腔镜检查与内镜检查联合作为胃神经内分泌肿瘤患者的一种治疗选择。
Combination of laparoscopy and endoscopy as an option for treatment patients with gastric neuroendocrine tumors.
作者信息
Kriger A G, Gorin D S, Kaldarov A R, Berelavichus S V, Marinova L A, Galkin G V
机构信息
A.V. Vishnevsky Institute of Surgery, Ministry of Health, 27 B Serpuhovskaja Street, Moscow, Russian Federation.
Abdominal Surgery Department No. 1, A.V. Vishnevsky Institute of Surgery, 5 Universitetskiy Prospect Street 289, Moscow, Russian Federation.
出版信息
J Surg Case Rep. 2019 Jan 31;2019(1):rjz007. doi: 10.1093/jscr/rjz007. eCollection 2019 Jan.
BACKGROUND
Neuroendocrine tumors (NETs) are relatively rare neoplasms with the increasing survival due to the development of early diagnostics. There is no universal position in treatment and follow up of small (~20 mm) gastric NETs.
CLINICAL CASES
Two female patients 51 and 66 y.o. with multiple gastric NETs <2 cm were observed in our department. In both cases treatment was performed by combination of two minimally invasive technologies: laparoscopy and gastroscopy. According to the localization of tumors in one case intraluminal gastric resection controlled by laparoscopy was performed. In the second case laparoscopic gastric resection with gastroscopy assistance was done.
DISCUSSION
There are two positions for surgical treatment of small NETs: to operate as the typical premalignant neoplasm or to make submucosa resections. We demonstrated combination of laparoscopy and gastroscopy as feasible approach with minimal risk of complications.
背景
神经内分泌肿瘤（NETs）是相对罕见的肿瘤，由于早期诊断技术的发展，其生存率有所提高。对于小型（约20毫米）胃神经内分泌肿瘤的治疗和随访尚无统一的方案。
临床病例
我们科室观察了两名分别为51岁和66岁的女性患者，她们患有多个直径小于2厘米的胃神经内分泌肿瘤。在这两个病例中，均采用了两种微创技术联合治疗：腹腔镜检查和胃镜检查。根据肿瘤的位置，其中一例进行了腹腔镜控制下的腔内胃切除术。另一例则在胃镜辅助下进行了腹腔镜胃切除术。
讨论
对于小型神经内分泌肿瘤的手术治疗有两种方案：将其作为典型的癌前肿瘤进行手术，或进行黏膜下切除术。我们证明了腹腔镜检查和胃镜检查相结合是一种可行的方法，并发症风险最小。
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