转移性黑色素瘤的小肠切除术
Small-bowel resection for metastatic melanoma.
作者信息
al-Sheneber I F, Meterissian S H, Loutfi A, Watters A K, Shibata H R
机构信息
Department of Surgery, Royal Victoria Hospital, McGill University, Montreal, Que.
出版信息
Can J Surg. 1996 Jun;39(3):199-203.
OBJECTIVE
To determine whether complete resection of small-bowel metastases from melanoma improves patient survival.
DESIGN
A computer-aided chart review.
SETTING
Hospitals associated with McGill University.
PATIENTS
Twenty patients (17 men, 3 women), identified from 1524 patients with melanoma, who underwent surgery to the small bowel for metastases. Patient age and clinical presentation, tumour site and stage were recorded.
INTERVENTION
Exploratory laparotomy with complete or partial resection of involved small bowel.
MAIN OUTCOME MEASURES
Operative morbidity, mortality and length of survival related to the extent of small-bowel resection.
RESULTS
Eleven patients had complete resection, 8 patients had partial resection and 1 patient had a palliative bypass only. Long-term survival (ranging from 2 to 10 years) was 36% in those who had complete resection and 0% in those who had partial resection; operative morbidity and mortality were 20% and 15% respectively.
CONCLUSION
Complete resection of small-bowel metastases in patients with metastatic melanoma can result in long-term survival.
目的
确定黑色素瘤小肠转移灶的完整切除是否能提高患者生存率。
设计
计算机辅助病历回顾。
研究地点
与麦吉尔大学相关的医院。
患者
从1524例黑色素瘤患者中识别出20例患者（17例男性，3例女性），他们因转移灶而接受小肠手术。记录患者年龄、临床表现、肿瘤部位和分期。
干预措施
行剖腹探查术，对受累小肠进行完整或部分切除。
主要观察指标
与小肠切除范围相关的手术并发症、死亡率和生存时长。
结果
11例患者接受了完整切除，8例患者接受了部分切除，1例患者仅行姑息性旁路手术。完整切除患者的长期生存率（2至10年）为36%，部分切除患者的长期生存率为0%；手术并发症发生率和死亡率分别为20%和15%。
结论
转移性黑色素瘤患者小肠转移灶的完整切除可带来长期生存。
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