巨大胃肠间质瘤1例MDT讨论

MDT discussion of a case of giant gastrointestinal stromal tumor

目的总结胃间质瘤的临床特点和诊治体会,以加深对胃肠间质瘤的认识,避免误诊和漏诊。方法回顾性分析云南省昆明市第一人民医院肝胆胰外科于2019年3月收治的1例巨大胃肠间质瘤患者的临床资料,该患者经MDT讨论确定治疗方式。结果结合患者资料,经影像科、心胸外科、肿瘤科和麻醉科医师多学科讨论后,选择了开腹肿瘤切除术,手术顺利。手术时间120 min,术中出血约100 mL,未输血。术后无出血、腹腔感染、胃食管反流等并发症发生,于术后第10天顺利出院,术后以伊马替尼辅助治疗。已随访4个月余,出院后未出现明显并发症,继续随访。结论胃肠间质瘤可采取多学科综合诊治模式,外科手术切除仍是最主要和最有效的治疗手段。

Objective To explore the clinical characteristics, diagnosis, and treatment norms of gastrointestinal stromal tumor, so as to deepen clinicians’ understanding of the gastrointestinal stromal tumor and avoid misdiagnosis. Methods The clinical data of a patient with gastrointestinal stromal tumor who treated in March 2019 in The First Hospital of Kunming was retrospectively analyzed, and determining the methods of the treatment through MDT mode. Results This patient was generally in good condition. After MDT discussions among the imaging department, cardiothoracic surgery department, oncology department, and anesthesia department, it was considered that surgical treatment was the best treatment scheme. The operation time was 120 min, intraoperative bleeding was about 100 mL, and no blood transfusion was performed. No bleeding, abdominal infection, gastroesophageal reflux, and other complications occurred after the operation, and the patient was discharged successfully on the 10 th day after the operation.Postoperative treatment was assisted by imatinib. Follow-up was conducted for more than 4 months, with no obvious complication occurred after discharge, so continued to follow-up. Conclusion Gastrointestinal stromal tumor can be diagnosed and treated by multidisciplinary approach, and surgical resection is still the most important and effective treatment.