残胃癌34例外科治疗与预后分析

Surgical treatment and prognosis analysis of gastric stump carcinoma in 34 cases

目的:探讨残胃癌的外科治疗及影响预后因素。方法:对34例残胃癌的外科治疗情况和预后进行回顾性分析。结果:首次胃切除以胃溃疡为主,占67.6%,首次手术B illrothⅡ式占85.3%。残胃癌早期缺乏特异的症状,首次手术距临床确诊残胃癌的间隔时间平均为16.1年。本组残胃癌手术切除率及根治性切除率分别为76.5%和52.9%,根治性切除患者1,3,5年生存率分别为82.4%,47.1%,35.3%,Ⅰ期、Ⅱ期患者的5年生存率为71.4%。结论:定期胃镜检查是早期诊断残胃癌的关键,根治性切除是治疗残胃癌的有效方法,病期及根治性切除是决定残胃癌预后的关键因素。

Objective To investigate the surgical treatment and prognostic factors of gastric stump carcinoma. Methods Surgical treatment and prognosis of 34 cases of gastric stump carcinoma were retrospectively analyzed. Results In 34 patients, 67. 6% patients underwent first gastrectomy resection with gastric ulcer and 85. 3% （29/34） received Billroth Ⅱ operation. Gastric stump carcinoma had no specific symptoms at the early stage. It was 16.1 years from the first operation to diagnosis of gastric stump carcinoma. Resection and radical resection rates were 76.5% and 52.9%. The 1-, 3- and 5-year survival rates were 82.4%, 47. 1% and 35.3%. The 5-year survival rate of Ⅰand Ⅱ stage patients was 71.4%. Conclusion Regular gastroscopy is vital in the early diagnosis of gastric stump carcinoma. Radical resection is an effective treatment method. Cancer staging and radical resection are the key prognostic factors, to gastric stump carcinoma.