[1]周鑫 谢海艇 谢凌铎 孙涛 修典荣 傅卫＊.腹腔镜下根治性手术切除直肠神经内分泌肿瘤(附7例报告)[J].中国微创外科杂志,2013,13(9):831-834.
　Zhou Xin,Xie Haiting,Xie Lingduo,et al.Laparocospic Radical Resection for Rectal Neuroendocrine Tumors: Report of 7 Cases[J].Chinese Journal of Minimally Invasive Surgery,2013,13(9):831-834.
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腹腔镜下根治性手术切除直肠神经内分泌肿瘤(附7例报告)()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
13
期数:
2013年9期
页码:
831-834
栏目:
短篇论著
出版日期:
2013-09-20

文章信息/Info

Title:
Laparocospic Radical Resection for Rectal Neuroendocrine Tumors: Report of 7 Cases
作者:
周鑫 谢海艇 谢凌铎 孙涛 修典荣 傅卫＊
北京大学第三医院普外科，北京100191
Author(s):
Zhou Xin;  Xie Haiting;  Xie Lingduo;  et al.
Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
关键词:
神经内分泌肿瘤; 直肠肿瘤
Keywords:
Neuroendocrine neoplasms; Rectal neoplasms
分类号:
R735.3+7
文献标志码:
A
摘要:
目的总结直肠神经内分泌肿瘤的临床诊断和治疗策略。方法2007年1月~2011年12月对7例直肠神经内分泌肿瘤行腹腔镜下根治性切除。游离肠管周围间隙后，肿瘤下缘2 cm以远断直肠，距肿瘤近侧端10 cm 处断结肠，端端吻合器腹腔内吻合乙状结肠及直肠断端。结果腹腔镜下切除6例，中转开腹1例。2例内镜下切除者行腹腔镜下根治术后病理标本内均未见癌灶残留；余5例中，4例病理诊断为类癌，1例病理诊断为神经内分泌肿瘤Ⅱ级。3例直肠周围淋巴结转移，其中2例伴有肝转移。7例随访12~58个月，平均25.3月，1例术后半年出现直肠腺癌肝转移，再次行腹腔镜下肝转移灶切除术；1例射频消融肝转移灶后11个月复查发现直肠神经内分泌肿瘤肝转移，再次行射频消融术；余5例无复发、转移。结论直肠神经内分泌肿瘤具有恶性潜能，对于存在高危因素的肿瘤应行根治性手术治疗或密切随诊。
Abstract:
ObjectiveTo explore the clinical diagnosis and treatment of rectal neuroendocrine neoplasms.MethodsFrom January 2007 to December 2011, laparoscopic radical resection was performed on 7 patients with rectal neuroendocrine neoplasms. After tissues surrounding the rectum were separated, the rectum was cut off at 2 cm distally, the sigmoid colon was cut off at 10cm proximally, and the anastomosis was done intraabdominally.ResultsSix cases underwent laparoscopic radical resection, and 1 case was converted to open surgery. Pathological specimens showed no residual tumor in 2 cases undergoing preoperative endoscopic resection. Four of the remaining 5 cases were diagnosed as “carcinoid”, and the remaining 1 case was diagnosed as neuroendocrine tumors(Grade Ⅱ). Perirectal lymph node metastasis was observed in 3 cases,of which 2 cases developed hepatic metastases.Seven patients were followed up for 12-58 months, with an average of 25.3 months, during which, 1 patient who was converted to open surgery experienced adenocarcinoma of hepatic metastases 6 months after operation, and underwent laparoscopic liver metastases resection; 1 case developed rectal neuroendocrine neoplasm of hepatic metastases 11 months after radiofrequency ablation and received radiofrequency ablation again; other 5 patients had no recurrence or metastasis.ConclusionRectal neuroendocrine neoplasms are potentially malignant, therefore radical resection or intense followup is required for tumors with potential metastasis.

参考文献/References:

[1]常虹，丁士刚，林香春，等.消化道类癌的诊断与治疗(附44例报告).中国微创外科杂志,2005,5(11):896-897.
[2]李克军，赵作伟，董擂，等.经肛门入路腔镜下高位直肠类癌局部切除术(附6例临床报告).中国微创外科杂志,2005,5(7):525-526.
[3]Hamilton SR, Abalone LA. World Health Organization Classification of Tumors. Pathology and Genetics of Tumors of the Digestive System. Lyon: LARC Press.2000.
[4]Bosman FT, Carneim F, Hruban RH, et al. WHO classification of tumors of the digestive system. Lyon: IARC Press.2010.
[5]Ramage JK, Ahmed A, Ardill J, et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut,2012,61(1):6-32.
[6]Caplin M, Sundin A, Nillson O, et al. ENETS Consensus Guidelines for the management of patients with digestive neuroendocrine neoplasms: colorectal neuroendocrine neoplasms. Neuroendocrinology,2012,95(2):88-97.
[7]Modlin IM, Oberg K, Chung DC, et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol,2008,9(1):61-72.
[8]Shields CJ, Tiret E, Winter DC. Carcinoid tumors of the rectum: a multiinstitutional international collaboration. Ann Surg,2010,252(5):750-755.
[9]Kim BN, Sohn DK, Hong CW, et al. Atypical endoscopic features can be associated with metastasis in rectal carcinoid tumors. Surg Endosc,2008,22(9):1992-1996.
[10]Shimizu T, Tanaka S, Haruma K, et al. Growth characteristics of rectal carcinoid tumors. Oncology,2000,59(3):229-237.
[11]Konishi T, Watanabe T, Kishimoto J, et al. Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years.Gut,2007,56(6):863-868.
[12]Alexandraki KI, Kaltsas G. Gastroenteropancreatic neuroendocrine tumors: new insights in the diagnosis and therapy.Endocrine,2012,41(1):40-52.

备注/Memo

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＊通讯作者，Email: fuwei0720@sohu.com
更新日期/Last Update: 2014-10-14