The diagnosis and surgical treatment of malignant gastrointestinal tumors in children / 中华消化杂志

ABSTRACT

Objective To investigate the essential points of the diagnosis and the surgical treatment of malignant gastrointestinal tumors in children.Methods Clinical data involved the sites and pathological types of the tumors,clinical manifestation,effective treatment and prognosis were retrospectively analyzed in 29 consecutive patients reffered to Beijing Children's Hospital between January 1996 and May 2008.Results Of 29 patients,26 were males and 3 were females(aged from 1 year and 10 month to 14 years,mean age of 10 years).Gastric tumor was found in 5 cases (interstitialoma in 1,lymphoma in 2,endodermal sinus tumor in 1 and P-J syndrome canceration in 1),whereas intestinal tumor was found in 24 cases(malignant Iymphoma in 17,colon carcinoma in 4 and carcinoid of appendix in 3).The main clinical manifestations were abdominal pain,emesia,fever,alimentary tract hemorrhage and emaciation.Surgical complication involved perforation,internal fistula,obstruction,invaginate and hemorrhage.Twenty-four patients underwent(gaster)intestine resection and anastomosis.Biopsy was performed in 5 patients.Two patients with colonic carcinoma relapsed 6 months to 1 year after operation.Of 29 patients,17 patients survived,6 patients missed the follow-up and 6 patients died.Conclusions Pediatric malignant gastrointestinal tumor is rare.The unspecific presentation makes the diagnosis difficult.In diagnosis of acute abdomen and gastrointestinal tract diseases,the possibility of malignant tumor should be reminded.The imaging and endoscopic examination are very important to diagnosis.The surgical resection or combined with chemotherapy are mainly used in treatment of tumors.The prognosis is related to the pathological nature of the tumor.