胃平滑肌肿瘤13例诊治分析

Diagnosis and Treatment of Gastric Leiomyoma(a Report of 13 Cases)

目的 :探讨胃平滑肌肿瘤的诊治方法。方法 :1996年 1月～ 2 0 0 2年 1月外科手术胃平滑肌肿瘤 13例 ,分析肿瘤生长的部位、方式、诊断方法、病理、治疗方式。结果 :肿瘤位于胃体部 8例 (6 2 % ) ,胃窦部 3例 (2 3% ) ,胃底部 2例 (15 % )。胃镜诊断率 5 4 % ,钡餐诊断率 75 % ,B超诊断率 6 9% ,CT诊断率 4 0 %。行胃次全切除术 5例 ,局部切除术 4例 ,全胃切除术 3例 ,姑息切除术 1例 (肝多发转移 )。病理诊断 :胃平滑肌瘤 7例 ,胃平滑肌肉瘤 6例。结论 :结合病史 ,多种辅助检查 (尤其是B超 )综合诊断 ,可提高术前的诊断率 ,治疗原则为手术切除。根据术中所见肿瘤大小。

Objective: To discuss the experience of diagnosis and treatment of gastric leiomyoma. Methods: 13 cases including 7 gastric leiomyoma amd 6 leiomyosarcoma from 1996.1 to 2002.1 were retrospectively reviewed and the tumor site, examining method, pathological results and treatment mode were analyzed. Results: 8 cases(62%)were in body of stomach, 3 cases(23%)were in antrum of stomach, and 2 cases(15%)were in fundus of stomach. Accurate rate of diagnosis of gastroscope, barium examining, ultrasound, and CT scan was 54%, 75%, 69%, and 40% respectively. 5 cases were adopted to subtotal gastroectomy, 4 cases were adopted to local gastroectomy, 3 cases were adopted to total gastroectomy, and one case with multiple metastasis of liver was accepted by palliative resection. Conclusion: Multiple exemining methods with history data can improve the accuracy of diagnosis, surgical resection should be performed according the tumor size and site, and pathological report.