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

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

  • 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。

     

    Abstract:
      Objective  To investigate the safety and feasibility of laparoscopy-assisted resection of simultaneous double primary carcinoma of the gastrointestinal tract.
      Methods  To retrospectively analyze the data of 11 patients who underwent laparoscopic resection for concurrent double primary carcinoma of the gastrointestinal tract in Inner Mongolia People's Hospital between January 2019 and April 2023, and discuss the safety and feasibility of laparoscopic adjuvant treatment of concurrent double primary carcinoma of the gastrointestinal tract considering the relevant literature.
      Results   The 10 males and one female had a mean age of 63.4 (44–81) years. Ten patients underwent laparoscopic treatment with the simultaneous resection of both primary cancers, while one underwent the procedure in two separate operations over a 5-month period. Overall, three patients had gastric cancer combined with colon and rectal cancer; five had colon cancer combined with rectal cancer; two had colon cancer combined with colon cancer; and one had small bowel cancer combined with colon cancer. The mean operative time was (317±141) min, mean intraoperative blood loss was (79±39) mL, mean postoperative hospital stay was (10.7±3.9) d, and median hospital treatment cost was 61,291 (39,767-117,196) Renminbi (RMB). All patients were successfully discharged after surgery; one patient experienced postoperative anastomotic bleeding. Patients were followed for (3-42) months: one was lost to follow-up, one developed local recurrence of the tumor at 6 months postoperative, and the rest survived with no significant signs of recurrence.
      Conclusions   Uniform guidelines for the treatment of multiple primary tumors are lacking; thus, identifying an anti-cancer treatment strategy is the greatest challenge for practitioners when patients are diagnosed with two active malignancies. Patients with concurrent multiple primary cancers of the gastrointestinal tract should be treated with concurrent radical tumor resection whenever possible to reduce surgery-associated trauma, reduce the length of hospital stay and treatment costs, and buy time for follow-up treatment.

     

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