54例胃癌切除标本断端癌细胞残留分析

Cancerous remnant at the cut ends after gastrectomy for the treatment of gastric carcinoma:an analysis of 54 cases

作者对54例胃癌切除标本断端癌细胞残留(断端阳性)情况进行分析。认为降低术后断端阳性率的因素有胃贲门癌的近侧根治性切除或全胃切除时,食管切缘距肿瘤的距离至少在3～6cm;在胃癌手术中,单纯经腹或经胸切口都会使胃癌近侧切除或全胃切除的范围受影响,而胸腹联合切口者,其断端阳性率远较前者为低。作者认为,提高胃癌外科手术的治疗效果应改变传统观念的影响,将十二指肠切除的范围给予充分考虑,还需加强对胃癌生物学行为的研究,使胃癌切除术更加规范。

In this study,54 cases of gastric carcinoma were found to have positive cancerous remnant at the cut ends after gastrectomy.It is the authors suggestion that in cases of cardial carcinoma,proximal subtotal gastrectomy or total gastrectomy should be performed under com- bined thoracoabdominal incision for a better exposure to have a 3～6 cm safe edge at esophageal cut end.The duodenal cut end should also have a longer than tradi- tionally received safe edge to prevent cancerous remnant.