胃大部分切除术后残胃癌26例临床诊治分析

Clinical Diagnosis and Treatment for Remnant Gastric Cancer Developed after Subtotal Gastrectomy:A Report of 26 Cases

目的:探讨残胃癌的早期诊断方法和外科治疗,观察不同手术方式对预后的影响。方法:对26例残胃癌的临床病理资料进行回顾性分析,比较胃镜和钡餐对残胃癌的诊断价值。结果:胃镜对残胃癌的诊断率为80.8%,钡餐为50.0%。手术切除的20例中根治性残胃切除13例均生存≥3年;姑息性切除7例,术后生存2年5例,1.5年2例。行胃空肠吻合4例中3例于6个月内死亡,1例生存10个月。2例腹腔内广泛转移者仅行肿块活检术。结论:胃镜对残胃癌的诊断价值优于钡餐。早期诊断并行根治性残胃切除患者预后较好。

Objective: To investigate the early diagnosis and surgical treatment of remnant gastric cancer (RGC) developed after suntotal gastrectomy. Methods: Clinicopathologic data of 26 cases of gastric RGC was studied retrospectively, and the diagnostic value of the gastroscopy and barium meal was compared. The effect of different operations on the prognosis of RGC was observed. Results: The diagnostic rate of gastroscopy and of barium meal was 80.8% and 50.0%, respectively. All the 20 cases who underwent radical remant gastrectomy survived postoperatively for more than 3 years. Five of the 7 cases who underwent palliative remnant gastrectomy survived for 2 years and 2 were alive in 1 year and a half postoperatively. In 4 cases of gastrojejunostomy, 3 died within half a year, 1 died in 1 year postoperatively. Conclusion: The diagnostic value of gastroscopy is superior to that of barium meal. The patients diagnosed earlier and treated by radical remnant gastrectomy have a better prognosis.