Midgut carcinoid tumours:: surgical treatment and prognosis
Midgut carcinoid tumours:: surgical treatment and prognosis
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DOI：
10.1016/j.bpg.2005.05.005
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发表时间：
2005-10-01
影响因子：
3.2
通讯作者：
Hessman, O
中科院分区：
文献类型：
--
作者：
Åkerström, G;Hellman, P;Hessman, O
起源于小肠的中肠类癌是类癌综合征最常见的原因。这些肿瘤通常进展缓慢，病程较长，尽管它们在确诊时经常出现转移，但手术治疗对它们的处理变得越来越重要。手术应包括努力切除肠系膜转移，这可能会导致严重的长期腹部并发症，典型的纤维性肠卡压和肠系膜血管受压导致的小肠缺血。也应该尝试手术切除或消融肝转移瘤，因为这可能对类癌综合征有相当大的缓解作用。对于类癌综合征患者，手术结合使用长效生长抑素类似物的持续生物治疗，可以缓解症状，稳定疾病或减缓进展。通过这种联合治疗，即使是晚期中肠类癌患者，也有望获得良好的存活率和可观的生活质量。
Midgut carcinoids originating in the small intestine are the most common cause of the carcinoid syndrome. These tumours typically progress slowly and have an extended disease course, and although they often present with metastases at diagnosis, surgical treatment has become increasingly important for their management. Surgery should include efforts to remove mesenteric metastases, which may cause severe long-term abdominal complications with typical fibrotic intestinal entrapment and small-bowel ischaemia due to compression of mesenteric vessels. Attempts should also be made to surgically remove or ablate liver metastases, since this may provide considerable palliation of the carcinoid syndrome. For patients with the carcinoid syndrome surgery is combined with continuous biotherapy with long-acting somatostatin analogues, which may alleviate symptoms and stabilize disease or slow progression. Favourable survival and appreciable quality of life can be expected with this combined treatment, even in patients with advanced midgut carcinoids.