目的探讨胃肠道平滑肌肉瘤的临床表现、诊断、外科手术处理原则及影响预后的因素。方法报告1972年～1995年78例胃肠道平滑肌肉瘤的诊断、手术处理及5年生存情况。结果本组胃肠道平滑肌肉瘤术前诊断率为(69.2％),消化道钡餐、CT 扫描及内窥镜检查阳性率分别达88.5％、63.6％、85.7％。术后5年生存率为65.9％。结论胃肠道平滑肌肉瘤的治疗效果及预后与肿瘤大小、病理分级、临床分期和是否掌握正确手术原则有密切关系。 Objective To investigate the clinical manifestation, diagnosis, principles of surgical treatment and factors influencing the prognosis of gastrointestinal leiomyosarcoma. Methods The diagnosis, surgical management, and 5-year survival of 78 patients with gastrointestinal leiomyosarcoma from 1972 to 1995 were reported. Results The preoperative diagnosis rate of gastrointestinal leiomyosarcoma in this group was (69.2%), and the positive rates of barium meal, CT scanning and endoscopy in the digestive tract were 88.5%, 63.6%, and 85.7%, respectively. The 5-year survival rate was 65.9%. Conclusion The therapeutic effect and prognosis of gastrointestinal leiomyosarcoma are closely related to the principle of tumor size, pathological grade, clinical stage and whether it is correct to grasp the principle of surgery.