胃癌切除术切端癌残留的原因、预后及预防

The Gause,Prognosis and Prevention of Positive Stump in Gastrectomy for Gastric Carcinboma

本文报告胃癌切除术切端癌残留２３例，残留率７．２％，食管切端癌残留１６例占６９．６％，一二指肠侧切端癌残留５例占２１．７％，食管侧切端和十二指肠侧切端均有癌残留２例占８．７％。姑息性胃癌切除术的切端癌残留率。Ｏ％，根治性胃癌切除术的切端癌残留率５．２％，二者经统计学检验无显著差异。远侧胃切除切端癌残留率６．４％，近侧胃切除和全胃切除术的切端癌残留率１１．１％，统计学检验无显著差异。２３例切端癌残留者的生存期为３～５７个月，平均１５．６个月，患者最终死于胃癌的局部复发和远处转移。作者对胃癌切除术切端癌残留率、发生原因、预后及预防作了讨论。

Twenty three cases of positive stump in gastrectomy for gastric carcinoma have been reported.The positive stump rate(PSR) was 7. 2%. Among them there were l6 case(69.6%)with cancer residual at esophageal ends,5 cases(21.7)%at duodenal ends, and 2 cases(8.17%)at both esophageal and duodenal ends. The PSR of palliative and radical resec-tion were 9.0%and 5. 2%,respectively.The PSR of distal part gastrectomy was 6.30%and the PSR of proximal part or total gastrectomy is 11.11%. There was no signiificant difference in statistical examination (P>0.05).The average survival time of 23 cases was 15.63 months,finally,these patients died of local recurrence and distant metastasis of gastric carcinoma. The cause,prognosis and prevention of positive stump in gastrectomy for gastric carcinoma were discussed.