胃肠道脂肪瘤的诊断与治疗

目的总结胃肠道脂肪瘤的诊断与治疗经验。方法回顾性分析1993年至2007年间收治的34例胃肠道脂肪瘤的临床资料。结果胃肠道脂肪瘤的临床表现无特异性,可并发肠套叠或肠梗阻,超声内镜的诊断准确率为93.8%。本组有12例行内镜下脂肪瘤切除术,22例行开腹手术（局部切除术及胃或肠部分切除吻合术）,手术过程顺利,未出现并发症。28例（82.4%）获1-168个月随访,1例胃底多发的脂肪肉瘤于术后2年死于肿瘤转移,其余27例均无复发或转移,存活至今。结论超声内镜是诊断胃肠道脂肪瘤的有效方法,手术是治疗胃肠道脂肪瘤的常规手段,内镜下切除胃肠道脂肪瘤可行。

Diagnosis and treatment of gastrointestinal lipoma

OBJECTIVE: To summarize the experience of diagnosis and treatment of gastrointestinal lipoma. METHODS: The clinical data of 34 patients with gastrointestinal (GI) lipoma from 1993 to 2007 were analyzed retrospectively. RESULTS: GI lipoma produced a variety of symptoms including gastrointestinal bleeding, abdominal pain, anemia, intussusception, and bowel obstruction. The diagnostic accuracy of endoscopic ultrasonography(EUS) for GI lipoma was 93.8%. Twelve GI lipomas were resected under endoscopy, the remainder at laparotomy, partial resection, gastrectomy or enterectomy being performed. Twenty-eight cases were followed up from 1 month to 168 months. No recurrence and metastasis were observed except one case dying of gastric liposarcoma. CONCLUSIONS: EUS is an effective method for diagnosing GI lipomas. The treatment of GI lipomas is surgical resection, and endoscopic removal of GI lipomas is safe following the guidance of the present therapeutic strategy.