Jain Nikhil, Soni Banshidhar, Khetan Ashish, Mishra Siddharth, Sharma Bhuwanesh, Bhojwani Rajesh
Department of Surgical Gastroenterology and Minimal Invasive Surgery, Santokba Institute of Digestive Surgical Sciences, Santokba Durlabhji Memorial Hospital and Medical Research Center, Jaipur, Rajasthan, India.
J Minim Access Surg. 2021 Apr-Jun;17(2):249-252. doi: 10.4103/jmas.JMAS_77_20.
The association of gastroenteropancreatic neuroendocrine tumours (GEP-NETs) with obesity has been reported and researched on. Rendering of a laparoscopic treatment treating these concurring pathologies in unison has not been described. Two morbidly obese patients with duodenal NETs underwent a resectional procedure, with curative intent, in the form of laparoscopic subtotal gastrectomy with roux-en-y gastrojejunostomy with partial duodenectomy and a laparoscopic one-anastomosis gastric bypass-mini gastric bypass with remnant gastrectomy and partial duodenectomy. Both patients had an uneventful convalescence with acceptable weight loss and no evidence of tumour recurrence on follow-up. The indolent nature of NETs, as compared to the morbidity of obesity provides the rationale for treating this particular cohort of patients with a surgical procedure that would serve to remove the tumour and also provide therapeutic benefit for obesity. With experience in advanced laparoscopic procedures, this can be accomplished safely with acceptable results.
胃肠胰神经内分泌肿瘤（GEP-NETs）与肥胖之间的关联已有报道并进行了研究。但尚未有关于同时处理这两种并存病症的腹腔镜治疗方法的描述。两名患有十二指肠神经内分泌肿瘤的病态肥胖患者接受了旨在治愈的切除手术，手术方式为腹腔镜次全胃切除术加roux-en-y胃空肠吻合术及部分十二指肠切除术，以及腹腔镜单吻合口胃旁路术 - 迷你胃旁路术加残胃切除术及部分十二指肠切除术。两名患者术后恢复顺利，体重减轻程度可接受，随访时无肿瘤复发迹象。与肥胖的发病率相比，神经内分泌肿瘤的惰性为采用既能切除肿瘤又能对肥胖起到治疗作用的手术方法治疗这一特定患者群体提供了理论依据。凭借先进腹腔镜手术的经验，这可以安全地完成并取得可接受的结果。
