胃肠道平滑肌肿瘤诊治体会

目的：探讨胃肠道平滑肌肿瘤的诊断及手术治疗。方法：对我院1986年1月至2001年6月收治的45例平滑肌肿瘤病人的临床资料进行回顾性分析。结果：胃平滑肌瘤行楔形切除10例，胃大切除6例，肉瘤行根治性胃次全切除术2例，小肠平滑肌瘤行肿瘤肠段切除12例，肉瘤行根治性切除5例，探查活检1例。结，直肠平滑肌瘤行肠段切除7例，肉瘤行根治术2例。随访40例，死亡7例，健在33例。结论：重视平滑肌肿瘤的结床，病理及形态学特点，及时总结仍的经验教训，是提高本病诊断率的关键。平滑肌瘤行肿瘤局切除，平滑肌肉瘤应行根治性切除，因对放，化疗均不敏感。

Experience on diagnosis and treatment of gastroenteric leiomyoma and leiomyosarcoma:analysis of 45 cases.

Objective To investigate and gain experience in the diagnosis and surgical treatment of gastroenteric leiomyoma.Methods A retrospective analysis was made on the clinical data of 45 cases of gastroenteric leiomyoma and leiomyosarcoma in our hospital from Jan.1986 to Jun.2001.Results The surgical treatments were:cuneate ectomy (n=10) and partial ectomy (n=6) of gastric leiomyoma;radical subtotal gastrectomy(n=2) of gastric sarcoma;partial ectomy(n=12) of enteric leiomyoma;radical ectomy(n=5) of enteric sarcoma;exploratory biopsy(n=1);partial ectomy(n=7)of colorectal leiomyoma,and radieal operation (n=2) of rectal sarcoma.40 patients were followed up,among them 7 died,33 were still living.Conclusion The key to more satisfactory accuracy in the diagnosis of leiomyoma is to pay attention to its characteristics in clinical pathology and morphology,and to draw lessons from misdiagnosis timely.Partial ectomy is suggested to be performed for the treatment of leiomyoma,and radical ectomy for leiomyosarcoma,since gastroenteric leiomyosarcomas are not sensitive to radiotherapy and chemotherapy.