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目的探讨胃间质瘤的诊治方法。方法回顾性分析40例胃间质瘤的临床表现、诊断和外科治疗。结果40例中最主要的临床症状为上腹部胀痛不适,经胃镜、胃肠钡透、CT及B超等检查发现,29例肿瘤位于贲门及胃底体部,11例位于胃窦部。40例均经手术切除,切除率为100%,14例(35.0%)行肿瘤单纯切除,11例(27.5%)行远端胃大部切除术,14例(35.0%)行胃近端切除,1例(2.5%)行全胃切除及胰尾和脾切除术。本组均获随访,平均3.5年,7例复发(17.5%),再次行肿瘤单纯切除术或含大网膜的肿瘤切除;4例死亡(10%),均为恶性患者。结论胃间质瘤治疗以手术为主,根据肿瘤部位、大小及病理结果选择不同术式,切缘至少距肿瘤3cm以上,不需常规行淋巴结清扫,术中保证肿瘤的完整性十分重要。
Objective To investigate the diagnosis and treatment of gastric stromal tumors. Methods The clinical manifestations, diagnosis and surgical treatment of 40 cases of gastric stromal tumors were retrospectively analyzed. Results The main clinical symptoms in 40 patients were discomfort and discomfort in the upper abdomen. Endoscopic examination, gastroenteroanatomy, CT, and B-ultrasound revealed that 29 cases were located in the cardia and gastric fundus and 11 cases in the gastric antrum. All 40 cases were surgically resected and the resection rate was 100%. 14 cases (35.0%) underwent simple resection of the tumor, 11 cases (27.5%) underwent distal gastrectomy, and 14 cases (35.0%) performed proximal gastrectomy. One patient (2.5%) underwent total gastrectomy and pancreatic tail and splenectomy. The group was followed up for an average of 3.5 years, 7 cases of recurrence (17.5%), re-surgery or resection of tumors with omentum resection; 4 deaths (10%), are malignant. Conclusion The treatment of gastric stromal tumors is based on surgery. According to the location, size and pathological results of the tumor, different surgical methods are selected. The margin is at least 3 cm away from the tumor. Routine lymph node dissection is not required. It is very important to ensure the integrity of the tumor during the operation.