重视残胃癌的诊断和治疗

Emphasis on the diagnosis and treament of the early remnant gastric stump carcinoma

残胃作为一种胃癌癌前状态,越来越受到人们的重视。残胃癌系胃部分切除术后的远期并发症,其临床表现无特异性,早期诊断困难。对于高危病人,内镜筛查应作为常规检查。残胃癌的手术应为残胃全切除和D2淋巴结清扫。由于残胃癌的淋巴引流途径和原发胃癌不同,因此其淋巴结清扫范围也应相应调整。根治性残胃全切后,残胃癌的预后可以和原发胃癌相同。

Gastric stump carcinoma （GSC） is a classical late complication of gastrectomy. Early diagnosis is difficult since suggestive clinical signs are usually associated with advanced tumors. Routine endoscopic screening should be performed for GSC patients with high risk factors. The treatment of choice for GSC should be the total removal of the gastric remnant including D2 lymphadenectomy. The pattern of lymph node metastases in GSC may differ from primary gastric cancer. Therefore, GSC may require a modified lymphadenectomy to include all important lymph node stations. After radical remnant gastrectomy, GSC has a prognosis similar to primary gastric cancer.