196例胃癌手术治疗体会

The Experience of 196 Cases of Gastric Carcinoma Operation

目的 探讨胃癌淋巴结廓清及手术方式的选择。方法回顾196例经腹胃癌切除患者的临床资料。结果 胃癌根治D2或D2+清除155例,其中淋巴结转移105例,姑息切除41例,全胃切除,食管空肠Roux-y 吻合95例,胃大部切除101例,联合胰体、尾部、脾切除2例,胃癌根治术后死因中肝转移18例,肺转移8例,骨转移2例,肾衰4例。结论 胃体以上近端胃癌行全胃切除D2或D2+清除为标准方式。胃窦癌可行胃大部分切除,但廓清淋巴结需包括1、7、8、9组和第12组,整个清扫面应于大小网膜外。

Objectice to explore the selection of operation mode and lymph nodes clearance forgastric carcinoma .Method we reviewed the data of 196 cases of gastric carcinoma who had undergonetransabdominal operation .Result 155 cases received D2orD2+radical operation,41cases received pallia-tive gastrectomy.Lymph nodes metastasis occurred in 105 cases.95 cases had undergone total gastrectomyand esophagojejunal anastomosis ,and the other 101 cases had undergone subtotal gastrectomy.A combinedresection of the spleen,corpus and cauda pancreatic was applied in 2 cases.In people who died afterradical operation,liver metastasis occurred in 18cases,lung metastasis in 8 cases,bone metastasis in 2cases,renal failure in 4 cases.Conclusion total gastrectomy plus D2orD2+lymph nodes clearance shouldbe a standard operation mode for proximal gastric carcinoma. For gastric antrum carcinoma ,the operationshould include subtotal gastrectomy,clearance of group1,7,8,9,12 lymph nodes ,resection of omentum majorand minor.