小肠间质瘤20例诊治分析

目的　总结小肠间质瘤诊断和治疗经验。方法　对1993—2 0 0 4年收治的2 0例小肠间质瘤的临床资料进行回顾性分析。结果　临床表现为黑便、果酱样血便14例、头晕9例、贫血3例,伴腹部疼痛11例,发病时间2个月至7年。确诊方式:剖腹探查12例,腹腔镜探查6例,小肠镜检查2例;手术方式:小肠间质瘤切除18例,胰十二指肠切除术1例,肿瘤无法切除行保守治疗1例。随访6个月至9年,除1例死于脑干出血、2例长期服用甲磺酸伊马替尼(Gleevec)症状部分缓解外,其余17例均健在,间质瘤无复发。结论　小肠间质瘤预后较好,但对不明原因的消化道出血应及早探查,以避免误诊;Gleevec对晚期小肠间质瘤有较好疗效

Diagnosis and treatment of stromal tumor of small intestine: experience in 20 patients

Objective To summarize the experience in the diagnosis and treatment of stromal tumor of small intestine. Methods Clinical data of 20 cases with postoperative pathologic diagnosis from May 1993 to May 2004 were retrospectively reviewed. Results Clinical symptoms and signs included melena, abdominal pain, dizziness and anemia with a history from 2 month to 7 years. In this group, 12 cases were diagnosed by exploratory laparotomy ,6 cases diagnosed by laparoscopic laparotomy, only 2 cases were diagnosed by small intestine endoscopy before operation. Laparoscopic or open small bowel resection was carried out in 18 cases, pancreatoduodenectomy in 1 case, and irresectable tumor was treated by imatinib mesylate in one case. All cases were followed-up from 6 months to 9 years, one case died of intracranial hemorrhage, two cases were on Gleevec treatment, the remaining 17 patients are all healthy and recurrence free. Conclusion Stromal tumor of small intestine lacks identifiable symptoms and signs, timely laparotomy helps to establish a diagnosis of stromal tumor of small intestine, Imatinib mesylate has satisfactory pathiative effect on late staged patients.