残胃癌28例临床分析及文献复习

Clincal analysis of 28 cases of gastric stump cancer and literature reviews

目的:探讨残胃癌的发病规律和临床特点。方法:回顾性总结28例胃癌临床资料并结合文献复习对残胃癌发生的时间、术式、病因及治疗等若干问题进行分析。结果:残胃癌多发生于男性,男女比例为21/7;BⅡ/BⅠ式比例为22/6,发病距初次手术时间5.5～28年,平均12年,确诊后多属晚期,能再次手术者14例,平均生存时间12.2个月,预后差。结论:残胃癌的发生与胃术后改变了胃肠解剖生理有密切关系,预防应从改进手术方式,防止胆汁反流等着手。对胃手术后5年以上的患者,应定期监测残胃癌的发生,一经确诊应争取全残胃根治术。

Objective：To study the incidence and clinical characteristics of gastric stump cancer.Methods：The pathogenic time,operative mode,cause of disease,treatment as well as related problems in the clinical data of 28 patients with gastric stump cancer were summarized retrospectively,and combined with literatures for the analysis.Results：Gastric stump cancer often took place in male,the ratio of men to women was 21/7.The occurrence rate of the type B Ⅱ was high,the proportin of type B Ⅱ to type B Ⅰ wss 22/6. The time from onset to the first operation was 5.5-28 years,with an average 12 years.Classically,patients were at advanced stage after confirmed diagnosis,among then re-operation was 14 patients with operative indication. The average survival time was 12.2 months,the prognosis was bad. Conclusion：The occurrence of gastric stump cancer is closely correlated with the changes of gastrointestinal anatomical physiology after operation.Prevention should improve the operative mode and prevent the bile regurgitation.The occurrence of gastric stump cancer should be detected on those patients with 5-year survival after operation.