原发性小肠肿瘤的外科治疗及其预后

Surgical treatment and prognostic factors of primary small intestine tumors

目的探讨原发性小肠肿瘤的临床特点、诊断及外科治疗经验。方法回顾性分析2010-05至2015-05于我院经手术治疗的87例原发性小肠肿瘤的临床资料,分析其临床表现、病理结果、手术情况、术后并发症及预后。结果 87例原发性小肠肿瘤均经病理确诊。常见临床表现有腹痛(51例)、消化道出血(29例)、腹部包块(12例)、肠梗阻(17例)、黄疸(3例),6例为查体发现。良性26例,恶性61例;26例良性肿瘤均行肿瘤及肠管局部切除,恶性肿瘤行根治性切除49例,姑息性切除4例,短路手术6例。59例获得随访,随访时间为6个月至5年,其中良性肿瘤23例,复发3例,恶性肿瘤36例,原位复发11例。结论小肠肿瘤临床表现不典型,早期诊断困难,手术切除是主要的治疗手段。

Objective To study the clinical characteristics,diagnosis and treatment of primary small intestine tumors（ PSIT）.Methods The clinical data of 87 surgical patients with PSIT between May 2010 and May 2015 were analyzed retrospectively,who were confirmed by operation and pathological study. Results The features of the small intestinal tumor could be abdominal pain（ 51 cases）,abdominal mass（ 12 cases）,hemorrhage（ 29 cases）,obstruction（ 17 cases）,jaundice（ 3 cases） and symptomless（ 6 cases）. There were benign（ n = 26） and malignant（ n = 61）. Partial excision was conducted in 26 cases of benign small intestinal tumor. Radical excision was performed in 49 cases of malignant tumors. Palliative excision in 4 cases and short-cut operation in 6 cases. Among them,59 cases were followed up for 6 months to 5 years. And 23 were benign. 3 cases had recurrence. Among 36 malignant cases,local recurrence occurred in 11 cases. Conclusions It is difficult to make an early diagnosis of primary small intestine tumor because of its atypical clinical manifestations. Surgical treatment is the principal therapy for the primary small intestine tumors.