腹腔镜辅助下切除消化道同时性双原发癌11例

冀富强 王举

冀富强, 王举. 腹腔镜辅助下切除消化道同时性双原发癌11例[J]. 中国肿瘤临床, 2023, 50(19): 993-998. doi: 10.12354/j.issn.1000-8179.2023.20230842
引用本文: 冀富强, 王举. 腹腔镜辅助下切除消化道同时性双原发癌11例[J]. 中国肿瘤临床, 2023, 50(19): 993-998. doi: 10.12354/j.issn.1000-8179.2023.20230842
Fuqiang Ji, Ju Wang. Laparoscopy-assisted resection of simultaneous double primary carcinoma of gastrointestinal tract: a series of 11 cases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(19): 993-998. doi: 10.12354/j.issn.1000-8179.2023.20230842
Citation: Fuqiang Ji, Ju Wang. Laparoscopy-assisted resection of simultaneous double primary carcinoma of gastrointestinal tract: a series of 11 cases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(19): 993-998. doi: 10.12354/j.issn.1000-8179.2023.20230842

腹腔镜辅助下切除消化道同时性双原发癌11例

doi: 10.12354/j.issn.1000-8179.2023.20230842
基金项目: 本课题受内蒙古自治区自然科学基金项目(编号:2022MS08062)资助
详细信息
    作者简介:

    冀富强:专业方向为胃肠外科临床与基础研究

    通讯作者:

    王举 wangju_86@163.com

Laparoscopy-assisted resection of simultaneous double primary carcinoma of gastrointestinal tract: a series of 11 cases

Funds: This work was supported by the Natural Science Foundation of Inner Mongolia Autonomous Region (No. 2022MS08062)
More Information
  • 摘要:   目的  研究探讨腹腔镜辅助下切除消化道同时性双原发癌的安全性和可行性。  方法  回顾分析内蒙古自治区人民医院2019年1月至2023年4月对消化道同时性双原发癌行腹腔镜切除的11例患者病例资料,并结合相关文献,讨论腹腔镜辅助治疗消化道同时性双原发癌的安全性及可行性。  结果  11例患者中男性10例,女性1例;平均年龄为63.4(44~81)岁;共有10例患者进行了同期双原发癌切除的腹腔镜治疗,1例患者在5个月内分2次完成手术。11例患者中胃癌合并结、直肠癌3例,结肠癌合并直肠癌5例,结肠癌合并结肠癌2例,小肠癌合并结肠癌1例。所有患者手术时间为(317±141)min,术中出血量(70±39)mL,术后住院时间(10.7±3.9)d,住院治疗费用61 291(39 767~117 196)元。所有患者采取手术治疗后均顺利出院,1例患者术后出现吻合口出血。患者随访时间为3~42个月,1例患者失访,1例患者在术后6个月发现肿瘤局部复发,其余患者均生存。   结论  多原发癌的治疗目前尚缺乏共识,当患者同时诊断出两种活动性恶性肿瘤时,找到抗癌治疗策略是临床面临的最大挑战。对同时性消化道多原发癌患者应尽量行同期的肿瘤根治术,减少手术带来的创伤并减少住院时间及治疗费用,为患者后续治疗争取时间。

     

  • 图  1  胃癌站位、乙状结肠癌站位及整体戳卡布局

    A:胃癌站位;B:乙状结肠癌站位;C:整体戳卡布局

    表  1  11例患者临床资料

    病例 性别 年龄(岁)   就诊主要症状   术前合并症   肿瘤位置
    1 76 乏力、消瘦 高血压、脑梗、房颤 横结肠、直肠
    2 49 乏力、头晕 回盲部、乙状结肠
    3 54 便血 冠心病、高血压、糖尿病 胃、乙状结肠
    4 58 便血 乙状结肠、直肠
    5 63 便血、腹泻 高血压、糖尿病 乙状结癌(双病灶)、直肠
    6 44 排便习惯改变 回肠肿瘤、升结肠
    7 65 便血 胃、直肠
    8 66 排便习惯改变 横结肠、乙状结肠
    9 69 便血、腹胀 全胃切除术后 横结肠、直肠
    10 72 呕吐伴腹痛停止排便 高血压、肠梗阻 胃、降结肠
    11 81 便血 升结肠、直肠
    下载: 导出CSV

    表  2  11例患者诊疗情况

    患者 手术时间(min) 术中出血量(mL) 并发症 术后住院时间(d) 术后病理分期 住院费用(元) 随访时间(月) 是否转移
    1 270 120 9 横结肠癌T3N0M0 63 601 36
    直肠癌TisN0M0
    2 360 100 12 回盲部癌T4N0M0 48 900 36
    乙状结肠癌T1N0M0
    3 300 30 9 胃癌T1N0M0 62 413 6
    乙状结肠癌T3N1M0
    4 240 20 吻合口出血 6 乙状结肠癌T3N0M0 51 669 33
    直肠癌T1N0M0
    5 285 80 10 乙状结肠癌T2N1M0 53 361 42
    直肠癌T1N0M0
    6 240 120 9 升结肠癌T4N2M0 52 097 18 第12个月淋巴结转移
    小肠癌T4N1M0
    7 610 80 21 胃癌T1N0M0 117 196 36
    直肠癌T3N0M0
    8 270 50 8 横结肠癌T3N0M0 66 930 4
    乙状结肠癌T1N0M0
    9 555 110 10 横结肠癌T4N1M0 49 058 6
    直肠癌T3N2M0
    10 150 20 11 胃间质瘤 39 767 9 第6个月复发
    降结肠T4N1N0
    11 210 40 13 升结肠癌T3N2M0 69 218 3
              直肠癌T3N1M0      
    下载: 导出CSV
  • [1] Sung H, Ferlay J, Siegel R L, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. doi: 10.3322/caac.21660
    [2] 姚海波,邵钦树.胃癌合并多原发癌的诊治进展[J].中华医学杂志,2020,100(26):2075-2077.
    [3] Warren S. Multiple primary malignant tumors: a survey of the literature and a statistical study[J]. Gastroenterology, 1932, 93(4):779.
    [4] Lv M, Zhang X, Shen Y, et al. Clinical analysis and prognosis of synchronous and metachronous multiple primary malignant tumors[J]. Medicine, 2017, 96(17):e6799. doi: 10.1097/MD.0000000000006799
    [5] Vogt A, Schmid S, Heinimann K, et al. Multiple primary tumours: challenges and approaches, a review[J]. ESMO Open, 2017, 2(2):e000172. doi: 10.1136/esmoopen-2017-000172
    [6] 邱敏,连岩岩,陆敏,等.多原发癌合并肾癌的治疗及预后[J].北京大学学报(医学版),2022,54(4):680-685. doi: 10.19723/j.issn.1671-167X.2022.04.016
    [7] Aydiner A, Karadeniz A, Uygun K, et al. Multiple primary neoplasms at a single institution: differences between synchronous and metachronous neoplasms[J]. Am J Clin Oncol, 2000, 23(4):364-370. doi: 10.1097/00000421-200008000-00011
    [8] Wang XK, Zhou MH. Clinical features and survival of patients with multiple primary malignancies[J]. World J Clin Cases, 2021, 9(34):10484. doi: 10.12998/wjcc.v9.i34.10484
    [9] Kato T, Suzuki K, Muto Y, et al. Multiple primary malignancies involving primary sporadic colorectal cancer in Japan: incidence of gastric cancer with colorectal cancer patients may be higher than previously recognized[J]. World J Surg Oncol, 2015, 13:1-7. doi: 10.1186/1477-7819-13-1
    [10] 黎琪,张标,牛丰南,等.合并结直肠癌双原发癌患者的临床病理特征、MSI及K-ras基因突变分析[J].中华医学杂志,2020,100(4):301-306
    [11] Zhai C, Cai Y, Lou F, et al. Multiple primary malignant tumors-a clinical analysis of 15,321 patients with malignancies at a single center in China[J]. J Cancer, 2018, 9(16):2795. doi: 10.7150/jca.25482
    [12] Amer MH. Multiple neoplasms, single primaries, and patient survival[J]. Cancer Manag Res, 2014, 6: 119-134.
    [13] Collatuzzo G, Ferrante M, Ippolito A, et al. Second primary cancers following colorectal cancer in sicily, Italy[J]. Cancers, 2022, 14(21):5204. doi: 10.3390/cancers14215204
    [14] Wang X, Fang H, Cheng Y, et al. The molecular landscape of synchronous colorectal cancer reveals genetic heterogeneity[J]. Carcinogenesis, 2018, 39(5):708-718. doi: 10.1093/carcin/bgy040
    [15] Zhao Y, Wu J, Pei F, et al. Molecular typing and clinical characteristics of synchronous multiple primary colorectal cancer[J]. JAMA Netw Open, 2022, 5(11):e2243457. doi: 10.1001/jamanetworkopen.2022.43457
    [16] Robles González MA, Villaseñor MP, Alfaro Cruz A, et al. Left perforated colonic tumor with synchronous locally advanced right colonic tumor[J]. Case Rep Gastroenterol, 2022, 16(3):652-662. doi: 10.1159/000520624
    [17] Fang J, Zheng Z, Huang Y, et al. Laparoscopy-assisted combined resection for synchronous gastrointestinal multiple primary cancers[J]. Int J Surg, 2015, 15:79-83. doi: 10.1016/j.ijsu.2015.01.021
    [18] 何玥,王雁,吉晨,等.同时性双原发性妇科恶性肿瘤23例临床分析[J].中华妇产科杂志,2022,57(5):352-360.
    [19] Almasan I, Piciu D. Triple primary malignancies: tumor associations, survival, and clinicopathological analysis: A 25-Year single-institution experience[J]. Healthcare (Basel), 2023, 11(5):738.
    [20] Lauter DM, Lau ST, Lanzafame K. Combined laparoscopic-assisted right hemicolectomy and low anterior resection for synchronous colorectal carcinomas[J]. SurgEndosc, 2003, 17:1498-1498.
    [21] Li Z, Wang D, Wei Y, et al. Clinical outcomes of laparoscopic-assisted synchronous bowel anastomoses for synchronous colorectal cancer: initial clinical experience[J]. Oncotarget, 2017, 8(6):10741. doi: 10.18632/oncotarget.12899
    [22] Ishiyama Y, Hirano Y, Hattori M, et al. Single incision laparoscopic surgery for multiple colorectal cancers[J]. Asian J Endosc Surg, 2016, 9(1):21-23. doi: 10.1111/ases.12245
    [23] 汤庆超,熊寰,王玉柳明,等.不同结直肠癌根治术的临床疗效与术后并发症影响因素分析(附3418例报告)[J].中华消化外科杂志,2023,22(1):131-143.
  • 加载中
图(1) / 表(2)
计量
  • 文章访问数:  105
  • HTML全文浏览量:  34
  • PDF下载量:  21
  • 被引次数: 0
出版历程
  • 收稿日期:  2023-07-10
  • 录用日期:  2023-09-19
  • 修回日期:  2023-09-18
  • 网络出版日期:  2023-11-15

目录

    /

    返回文章
    返回