胃癌旷置术在晚期胃癌手术治疗中的应用

Application of Devine Exclusion in the Treatment of Late Gastric Cancer

本文报道对２１例因并发幽门梗阻或上消化道出血而不能切除的胃癌采用Ｄｅｖｉｎｅ胃癌旷置术治疗。全部病例癌均浸润与胃周组织粘连成块而无法切除，其中与胰、横结肠、肝、十二指肠韧带粘连最多。患者中２０例行胃癌旷置术加胃空肠吻合术，占９５。２％。结果除１例术后早期死于肝昏迷外，其余均好转出院，术后随访无１例死于幽门梗阻，平均存活９．１个月。作者结合病例对胃癌旷置术在晚期胃癌手术治疗中的价值及胃癌旷置术具体实施的条件进行了讨论。

This paper reports Devine exclusion in the treatment of 21 cases of gastric cancer unresectable due to complicated pyloric obstruction or hemorrhage of upper gastrointestinal tract.In all cases the cancer infiItrated and got adhesion into masses with tissues of organs surrounding stomach(especially with pancreas,transverse colon, hepatoduodenal ligament),and therefore can not be resected.Twenty cases(95.2%)of them were performed Devine exclusion and gastrojejunostomy. All operated patients were discharged from hospital with better condition except one died of hepatic coma in the early period afteroperation. The mean sruvival time of patients was 9.1 months,The value of Devine exclusion in the operative treatment of late gastric cancer and the requirements for its practical performance are discussed.