Petrasova Natalia, Snajdauf Jiri, Petru Ondrej, Frybova Barbora, Svojgr Karel, Linke Zdenek, Mixa Vladimir, Kodet Roman, Kyncl Martin, Rygl Michal
Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
Pediatr Surg Int. 2020 Aug;36(8):917-924. doi: 10.1007/s00383-020-04698-w. Epub 2020 Jun 19.
Analysis of surgical management and survival of pediatric patients with gastric tumors treated at our institution.
A retrospective study of patients with primary gastric tumors treated between 1993 and 2018 was conducted.
Eight patients, five girls and three boys, were diagnosed with gastric tumors at an average age of 10.4 years (1 day-15.4 years). Surgical management included Billroth type I procedure in five and tumor excision in three patients. Histology revealed gastrointestinal stromal tumor (GIST) in four patients and one of each of schwannoma, myofibroblastic tumor, hamartoma and teratoma. Microscopically clear margins were reported in six patients. Repeated local recurrence occurred in three patients (2 × GIST, 1 × myofibroblastic tumors) who consequently underwent three, four and six reoperations. One of these patients had liver metastases, which were managed with ligation of the hepatic arteries. This patient was also diagnosed with a lung hamartoma, which was treated with a lobectomy. Survival rate was 100% with a median follow-up of 8.6 years (7 months-25.5 years).
Gastric tumors are rare in children and represent a management challenge. Repeated recurrence of GISTs and myofibroblastic tumors remains frequent even after complete resection and may necessitate multiple surgeries, therefore patients require a lifelong follow-up.
分析在我院接受治疗的小儿胃肿瘤患者的手术治疗及生存情况。
对1993年至2018年间接受原发性胃肿瘤治疗的患者进行回顾性研究。
8例患者，5名女孩和3名男孩，平均年龄10.4岁（1天至15.4岁），被诊断为胃肿瘤。手术治疗包括5例行毕Ⅰ式手术，3例行肿瘤切除术。组织学检查显示，4例为胃肠道间质瘤（GIST），1例为神经鞘瘤、肌纤维母细胞瘤、错构瘤和畸胎瘤各1例。6例患者镜下切缘清晰。3例患者（2例GIST，1例肌纤维母细胞瘤）出现局部复发，因此分别接受了3次、4次和6次再次手术。其中1例患者有肝转移，通过肝动脉结扎进行治疗。该患者还被诊断为肺错构瘤，接受了肺叶切除术。中位随访8.6年（7个月至25.5年），生存率为100%。
胃肿瘤在儿童中罕见，是一个治疗挑战。即使在完全切除后，GIST和肌纤维母细胞瘤仍频繁复发，可能需要多次手术，因此患者需要终身随访。
