腔外型胃平滑肌肿瘤

Exogastric tumors of gastric smooth muscle

目的总结腔外型胃平滑肌肿瘤的诊断及治疗经验.方法回顾性分析过去$%年?@例腔外型胃平滑肌肿瘤的临床特点、辅助检查的准确率以及手术方式.结果?@例腔外型胃平滑肌肿瘤占同期胃平滑肌肿瘤的#@A #B ,主要临床表现为腹部包块'CA &B ,消化道出血'CA &B及腹部不适''A 'B .术前胃肠钡餐及胃镜检查准确率分别为"CA &B及?!A CB ,术前确诊率为?&A ?B .手术以胃楔形切除及胃大部分切除为主.结论腔外型胃平滑肌肿瘤早期缺乏特异性临床表现,易误诊.胃肠钡餐及胃镜联合D超和(E可提高确诊率.治疗上以胃楔形切除及胃大部分切除为主,不必常规清扫淋巴结.

Objective To ivestigate the clinical features, diagnostic methods and treatment principles of exogastric gastric smooth muscle tumor. Method Clinical presentations, diagnostic procedures and surgical treatments of 48 cases with exogastric gastric smooth muscle tumor during past 20 years were analyzed retrospectively.Results Fourty- eight cases of exogastric gastric smooth muscle tumors accounted for 68 6% of all the patients with gastric smooth muscle tumors. Abdominal mass, gastrointestinal bleeding, and abdominal discomfort were the most common symptoms, occurring in 37 9% , 37 9% and 33 3% patients respectively. The accuracy rates of preoperative diagnosis with upper gastrointestinal barium study and gastric endoscopy were 57 9% and 41 7% . The overall accuracy rate of preoperative diagnosis was 49 4% . The most common types of resection were wedge resection and partial gastrectomy.Conclusions Misdiagnosis rate is high in exogastric tumors because of lack of specific clinical manifestations during the early stage. Upper gastrointestinal barium study and gastric endoscopy, in combination with ultrasonography and CT, can increase the accuracy rate of diagnosis of such disease. The main surgical managements are wedge resection and partial gastrectomy, and routine lymphadenectomy is not necessary.