全胃切除术治疗胃癌的评价(附169例报告)

Evaluation of Total Gastrectomy in the Treatment of Stomach Cancer.Analysis of 169 Cases

本文报告全胃切除术治疗胃癌169例的经验。术后总的1、3和5年生存率分别为70.4％,40.0％和 23.3％。根据本组经验认为高位胃体癌,全胃癌、多原发癌、残胃癌、胃底贲门癌应行全胃切除,术中肉眼判断癌已侵及浆膜层者宜行全胃合并脾胰尾切除。本文改进的空肠原位间置代胃消化道重建术能恢复十二指肠自然通道,具有代胃,又能防止返流性食管炎,倾倒综合征,提高术后生存质量的优点,值得推广应用。

From July 1972 to April 1989,169 cases of gastric cancer were treated by total gastrectomy. The 1-, 3-, and 5- year survival rats were 70.4%, 40. 0%, 23,3%, respectively. The indications for total gastrectomy were cancer involving the whole stomach ,the body, the cardia, the fundus, stump carcinoma as well as multiple primaries of the stomach. Under circumstance of serosal invasion total gastrectomy and splenectomy should be done. Jejunal interpos- ing replacement procedure that was modified by us is the choice of reconstruction following total gastrectomy. This pro- cedure restores the duodenal natural pathway with reservation of the reservoir function ,preventing the reflux esophagitis from occurrence and improve quality of life postoperatively.