【摘要】 目的 總結胃間質瘤的診斷及治療方法。 方法 回顧性分析2005年10月-2009年10月收治的15例胃間質瘤患者的臨床資料。 結果 患者的主要臨床表現為消化道出血、腹痛、腹脹、貧血等，全部手術切除。主要根據胃間質瘤大小和部位決定手術方式。有6例行胃大部切除，8例行胃楔形切除，1例經腹腔鏡行胃楔形切除。 結論 胃間質瘤術前難以明確診斷，確診有賴于術后病理和免疫組織化學檢查，手術切除仍是治療胃間質瘤的主要手段。【Abstract】 Objective To summarize the clinical experience in diagnosing and treating gastric stromal tumor. Methods The clinical data of 15 patients with gastric stromal tumor admitted from October 2005 to October 2009 was retrospectively reviewed. Results Among these patients, the clinical manifestations mainly included gastrointestinal bleeding, abdominal pain, abdominal flatulence, and anemia. All patients had undergone surgical resections. Mainly based on the size and location of the gastric stomal tumor, a specific operative procedure was decided for each patient. Of these patients, subtotal gastrectomy had been performed on six, gastric wedge resection on eight, and laparoscopic gastric wedge resection on one. Conclusion It is difficult to confirm the diagnosis of gastric stromal tumor before the operation. The diagnosis is usually confirmed by postoperative pathological and immunohistochemical examinations. Surgical resection remains to be the major therapeutic approach for gastric stromal tumor.
ObjectiveTo investigate the clinical value of small-for-size left lobe liver auxiliary partial orthotopic liver transplantation (APOLT) in the treatment of decompensated cirrhosis. MethodThe preoperative and postoperative clinical data of 4 patients who received small-for-size left lobe liver APOLT in 2023 were retrospectively described and analyzed. ResultsOne patient suffered metabolic liver disease cirrhosis and the other three suffered hepatitis B cirrhosis, all of whom presented with decompensated cirrhosis. Preoperative evaluation showed that the graft-to-recipient weight ratio was less than 0.6%. All recipients underwent left hemihepatectomy. The grafts were derived from living donors in 3 cases, from donation after citizen death in 1 case. After APOLT treatment, 4 patients and grafts survived, 1 patient experienced transplantation rejection and recovered after modified anti-rejection therapy. Three patients with hepatitis B cirrhosis were treated with nucleoside analogues and hepatitis B immunoglobulin, the hepatitis B virus DNA was negative at the end of follow-up, one of three patients with hepatitis B cirrhosis showed negative results for hepatitis B virus in the graft biopsy at month one after surgery. ConclusionsFrom the summary results of these cases, small-for-size left lobe liver APOLT can be used to treat decompensated cirrhosis. The application and popularization of this treatment regimen is expected to expand the donor pool and benefit more decompensated cirrhosis patients with lower Model for End-stage Liver Disease score.