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[胃息肉。临床及治疗方面的考量]

[Stomach polyps. Clinical and therapeutic considerations].

作者信息

Briccoli A, Guarasci N, Pezcoller C, Pirazzoli P P, Ricchi E, Saviano M S

出版信息

Minerva Chir. 1981;36(13-14):905-28.

PMID:7022265
Abstract

The main clinical and therapeutic problems of gastric polyps are examined on the basis of 7 personal cases and the literature on the subject. 5 of the cases were adenomatous polyps proper, one of them in malignant degeneration and associated with polyposis of the large intestine. In 2 other cases, the histopathological picture revealed Peutz-Jeghers type hamartomatosis polyps confined to the gastric region without the typical cutaneo-mucous stigmata or familial character. Classification of polyps must allow not only for aetiopathogenetic or clinical criteria but for histopathological and histogenetic criteria also. A clear-cut distinction must be made between adenomatous polyps, of definite malignant potential, and pseudoneoplastic polypoid lesions that are essentially benign. The main diagnostic techniques available to handle a symptomatology that is often oligosymptomatic and aspecific, or associated with complications (such as ulcers, haemorrhage, stenosis or, not least, malignant transformation) are reviewed and stress laid on the importance of endoscopy prior to histopathological study which is of value only if carried out on a totally removed polypous lesion. The guidelines for indicating and selecting the radial surgical technique are presented.

摘要

基于7例个人病例及该主题的文献,对胃息肉的主要临床和治疗问题进行了研究。其中5例为典型腺瘤性息肉,其中1例发生恶变并伴有大肠息肉病。另外2例的组织病理学表现为局限于胃区的Peutz-Jeghers型错构瘤性息肉,无典型的皮肤黏膜体征或家族特征。息肉的分类不仅必须考虑病因发病机制或临床标准,还必须考虑组织病理学和组织发生学标准。必须明确区分具有明确恶性潜能的腺瘤性息肉和本质上为良性的假性肿瘤性息肉样病变。本文回顾了用于处理通常症状较少且不具特异性或伴有并发症(如溃疡、出血、狭窄或尤其是恶变)的症状的主要诊断技术,并强调了在组织病理学研究之前进行内镜检查的重要性,只有对完全切除的息肉样病变进行组织病理学研究才有价值。文中还介绍了选择根治性手术技术的指导原则。

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