胃大部切除术后残胃贲门癌的诊治

TREATMENT OF GASTRIC REMNANT CARDIAC CARCINOMA AFTER VENTRICULUS ECTOMY

目的 总结胃大部切除术后残胃贲门癌的诊断及外科治疗。方法 回顾性分析 1 996年 6月— 2 0 0 3年 6月我院收治的 1 5例术后残胃贲门癌患者 ,胃大部切除术到残胃贲门癌确诊时间为 4～ 2 6年。所有病例均行上消化道造影检查及胃镜检查 ,均能术前确诊。本组病例全部接受手术探查 ,其中 1 0例行残胃全切除并食管空肠Roux -Y吻合术 ,5例因肿瘤无法切除而改行胃、肠营养管造瘘术。结果 全组无手术死亡 ,无吻合口瘘发生 ,均顺利康复出院。结论 胃大部切除术后 1 0年为残胃贲门癌发病高峰期 ,上消化道钡餐及胃镜检查是本病早期诊断的重要手段 ,治疗以手术切除为主 ,主张行残胃全切除并食管空肠Roux -Y吻合术重建消化道。

Objective To investigate diagnosis and treatment of gastric remnant after ventriculus ectomy. Methods 15 patients with gastric remnant cardiac carcinoma treated in our hospital from June 1996 to June 2003,the final diagnosis time from ventriculus ectomy to gastric remnant cardiac carcinoma being 4 to 26 years,were retrospectively analyzed.All the patients were performed upper digestive tract tomography and gastroscope,and all were made final diagnosis before surgery.Surgical exploration were performed to all,of which 10 cases were performed gastric remnant resection and oesophagus-jejunum anastomosis. Results All the patients were recovery without death and costomy fistulization. Conclusion 10 years after ventriculus ectomy is the peak occur time of gastric remnant cardiac carcinoma.Upper digestive tract barium meal and gastroscope are the important means to diagnose gastric remnant cardiac carcinoma,and surgery resection is the main method of treatment,and gastric remnant resection combined oesophagus-jejunum anastomosis is suggested.