小肠恶性肿瘤的诊断与外科治疗122例分析

目的探讨小肠恶性肿瘤的临床病理特点及外科治疗结果，以提高外科诊疗水平。方法回顾性分析122例小肠肿瘤的临床资料及随访结果。结果本组小肠恶性肿瘤122例中男81例，女41例，平均年龄53．5岁。病灶位于十二指肠31例（25．4％），空肠37例（30．3％），回肠54例（44．3％）。总的术前诊断率为27．9％，包括十二指肠肿瘤术前诊断率为87．1％，空肠肿瘤为5．4％，回肠肿瘤为13．5％。本组行胰十二指肠切除31例，右半结肠根治性切除13例，小肠部分切除70例，旁路手术3例及活检术5例。本组1、3及5年生存率分别为75％、40％及21％。结论手术切除是治疗小肠恶性肿瘤的主要手段，而早期诊断是提高疗效的关键。

Diagnosis and surgical treatment of primary malignant small bowel tumor

Objective To explore the clinicopathological characters and surgical outcome of primary malignant small intestine tumor and to improve the level of diagnosis and therapy. Methods The clinical data and follow-up of 122 patients with primary malignant small bowel tumor were analyzed retrospectively.Results One hundred and twenty-two patients with primary malignant small bowel tumor were studied, Among them 81 were male and 41 were female, with a male to female ratio of 2.0:1, and the mean age was 53.5 years. Tumors located at the duodenum were noted in 31 patients, at the jejunum in 37 patients, and at the ileum in 54 patients, The rate of preoperative diagnosis rate was 27.9%, including a diagnosis rate of 87.1% for duodenal tumor, 5.4% for jejumal tumor, and 13.5% for ileum tumor. The surgical procedures included pancreaticoduodenectomy in 31 patients, radical right hemicolectomy in 13 patients, and segmental bowel resection in 70 patients, bypass operation in 3 patients, laparotomy and biopsy in 5 patients. The 1-, 3-, and 5-year survival rates in this group were 75%, 40% and 21%, respectively. Conclusions Surgical treatment is the principal therapy of primary malignant bowel tumor, and early diagnosis is essential to the improvement of therapeutic effect.