发生于胃的胃肠间质瘤外科治疗

目的:探讨发生于胃的胃肠间质瘤(GIST)外科治疗的方法。方法:对1995年8月-2005年8月收治的经手术病理证实的19例胃GIST进行回顾性研究。结果:19例患者中,肿瘤位于贲门胃底区7例,胃体9例,胃窦3例。肿瘤最小2cm,最大25cm,中位大小6cm。胃周淋巴结转移1例。手术行胃楔形切除11例,近端胃大部切除5例,远端胃大部切除3例,其中联合脏器切除3例。查免疫组织化学CD117阳性16例,CD34阳性17例。术后随诊5例复发转移。结论:胃GIST治疗以手术为主,术中应根据肿瘤大小、部位、有无外侵及淋巴结转移决定手术范围,切除在于完全而不在于大范围清扫。

Surgical treatment of gastrointestinal stromal tumors of stomach

Objective:To investigate the surgical treatment of gastrointestinal stromal tumors(GIST)of stomach.Methods:The clinical data of 19 cases with GIST of stomach were analyzed retrospectively.Results:Tomors were found by gastroscopy,barium meal and computer tomography.The preoperational diagnosis of GIST was 13 cases,and only 4 with pathological evidences.GIST located at cardia and gastric fundus in 7 cases,gastric body in 9 cases and gastric antrum in 3 cases.Diameter of tumors was from 2 cm to 25 cm.Only one case had perigastric lymph node metastasis.All cases underwent resection,of which wedged resection in 11 cases,distal subtotal gastrectomy in 3 cases,proximal gastrectomy in 5 cases,conbined with other organs resection in 3 cases.Immunohistochemistry staining showed CD117 positive in 16 cases,CD34 positive in 17 cases.5 cases recurred or metastasized.Conclusion:Surgical approcch remains the major treatment for GIST of stomach.Operation should be designed according to tumor location and tumor size and other findings during the operation.Complete resection and prevention of tumor rupture should be focused on and no routine lymphatic clearance be required.