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绒毛状腺瘤在直肠、远端结肠并不少见,也可存在于胃肠道任何部位,除结、直肠外最好发于十二指肠。有证据表明,十二指肠绒毛状腺瘤(VAD)有潜在的恶变危险。 1976~1983年作者在两个外科医院治疗了5例VAD。1例发生恶变,作胰十二指肠切除术,随访2年,依然生存。4例切开十二指肠作肿瘤局部切除术,其中1例术后1年内复发并恶变,3例术后随访1~4年无复发征象。讨论:VAD发生恶变者不少。Perzin和Bride报导,20例小肠绒毛状腺瘤中有17例发生恶变(占85%)。本文报导的5例VAD中,4例位于乏特氏乳头附
Villous adenomas are not uncommon in the rectum and distal colon. They can also be found in any part of the gastrointestinal tract. Except for the nodes and the rectum, they are best distributed in the duodenum. There is evidence that duodenal villous adenomas (VAD) are potentially dangerous for malignant transformation. From 1976 to 1983, the author treated five cases of VAD in two surgical hospitals. In 1 case, malignant transformation was performed for pancreatoduodenectomy. After 2 years of follow-up, it survived. In 4 patients, the duodenal incision was made for local resection of the tumor. One patient had recurrence and malignant transformation within 1 year after operation. Three patients were followed up for 1 to 4 years without recurrence. Discussion: There are many vicious variants of VAD. Perzin and Bride reported that 17 of 20 small intestinal villous adenomas had malignant transformation (85%). Of the 5 cases of VAD reported in this paper, 4 were found in the Vet’s nipple attachment.