Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20090, Pieve Emanuele, Milan, Italy.
Surgical Oncology Unit, Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
Updates Surg. 2019 Sep;71(3):451-456. doi: 10.1007/s13304-019-00667-8. Epub 2019 Jul 3.
Duodenal resections are sometimes necessary for radical surgery. We analyzed technical aspects and post-operative outcomes in patients with RPS and GIST involving duodenum. We identified patients who underwent duodenal resection for RPS and GIST at our Institute between 2000 and 2016. Clinical, pathological and treatment variables were analyzed. Thirty patients were treated: 15 for GIST, 15 for RPS. Sixteen duodenal wedge resections (WR) and 14 segmental resections (SR) were performed. Multi-organ resection was frequently performed (63.4%). Median time to flatus was 3 days (range 1-6), to oral refeeding 4.5 (range 2-15). Overall postoperative morbidity rate was 53% (16/30): Clavien Dindo grade ≤ II: 10; duodenum-related complication rate was 33% (10/30), Clavien Dindo grade ≤ II: 9. Morbidity rates were higher in SR than WR. Duodenal resections for RPS and GIST have significant morbidity rate and whenever it is possible, WR is preferable to SR because of the lower morbidity rate.
十二指肠切除术有时是根治性手术所必需的。我们分析了涉及十二指肠的 RPS 和 GIST 患者的技术方面和术后结果。我们在 2000 年至 2016 年期间在我们的研究所确定了因 RPS 和 GIST 而行十二指肠切除术的患者。分析了临床、病理和治疗变量。共治疗了 30 例患者：15 例 GIST，15 例 RPS。行 16 例十二指肠楔形切除术（WR）和 14 例节段切除术（SR）。经常进行多器官切除术（63.4%）。排气中位数时间为 3 天（范围 1-6），口服喂养为 4.5 天（范围 2-15）。总的术后发病率为 53%（16/30）：Clavien Dindo 分级≤ II：10 例；十二指肠相关并发症发生率为 33%（10/30），Clavien Dindo 分级≤ II：9 例。SR 的发病率高于 WR。RPS 和 GIST 的十二指肠切除术发病率较高，只要可能，WR 优于 SR，因为 WR 的发病率较低。
