腹腔镜同期手术治疗胃神经内分泌癌肝转移1例

胃神经内分泌癌（Gastric neuroendocrine carcinoma,G-NEC）是一类少见的起源于胃神经内分泌细胞的高度恶性肿瘤。GB-NEC 侵袭性强,易于发生淋巴结和远处转移,预后较差。肝脏是G-NEC 最常见的远处转移部位。目前,对于G-NEC 伴肝脏转移的治疗仍存在争议,尚无腹腔镜手术治疗G-NEC 伴肝转移的相关报道。在这里,本文回顾性分析了1 例G-NEC 伴肝转移患者的临床特点和诊治经过。患者因“恶心伴食欲不振3 个月”入院,结合病史、体格检查及辅助检查结果,术前考虑诊断为胃恶性肿瘤伴肝转移,接受了腹腔镜胃癌根治术（全胃切除+食道空肠Roux-en-Y 吻合+D2 淋巴结清扫）+左肝外叶切除+空肠造瘘术,术后无严重并发症发生并顺利出院。术后予以6 个周期的“依托泊苷+顺铂”方案化疗,随访患者术后2 年未见肿瘤复发。

Laparoscopic concurrent operation for liver metastasis of gastric neuroendocrine carcinoma:a case report

Gastric neuroendocrine carcinoma (G-NEC) is a rare type of highly malignant tumor originating from gastric neuroendocrine cells.GB-NEC is highly invasive,prone to lymph node and distant metastasis,and has a poor prognosis.Liver is the most common site of distant G-NEC metastasis.At present,the treatment of G-NEC with liver metastasis is still controversial.Laparoscopic surgery for G-NEC with liver metastasis has not been reported.In this paper,we retrospectively analyzed the clinical features,diagnosis and treatment of a patient with G-NEC associated with liver metastasis.The patient was admitted with nausea and anorexia for 3 months.Combined with the medical history,physical examination and auxiliary examination results,the preoperative diagnosis was considered as gastric malignant tumor with liver metastasis.The patient were given laparoscopic radical gastrectomy (total gastrectomy+Roux-en-Y esophagus jejunal anastomosis+D2 lymph node dissection)+left extrahepatic lobectomy+jejunostomy.No serious complications were observed after surgery and the patient was discharged successfully.Six cycles of etoposide+cisplatin chemotherapy were given postoperatively,and no tumor recurrence was observed in the patients after 2 years of follow-up.