术后残胃癌临床诊治分析

Clinical analysis of diagnosis and treatment of gastric remnant carcinoma after operation

目的:探讨术后残胃癌的诊断及外科治疗方法。方法:对我院2002年1月～2008年2月收治的24例残胃癌患者的临床资料进行回顾性分析。结果:24例病例中行根治性手术14例(58.3%),姑息性手术8例(33.3%),急诊剖腹探查1例(4.2%)。根治性切除组和姑息性切除组1、3、5年生存率分别为100.0%、76.4%、45.7%和57.2%、22.8%、0。两组比较,差异有统计学意义(P<0.05)。结论:残胃癌多发生于毕Ⅱ式胃大部切除术后10年以上的患者,胃镜及胃黏膜活检是确诊残胃癌的主要手段,定期对胃大部切除术患者行胃镜复查,是残胃癌早期诊断的主要方法,根治性手术可提高患者的生存率。

Objective： To explore the diagnosis and surgical treatment of gastric remnant carcinom after operation. Methods： From January 2002 to February 2008, the clinical data of 24 patients with gastric remnant carcinoma in our hospital were retrospectively analyzed. Results： Of 24 cases, 14 cases （58.3%） were radical surgical operation treantment, 8 cases （33.3%） were operated with palliative surgery, and 1 case （4.2%） was operated with emergency exploratory laparotomy. 1, 3, 5 years survival rates of radical resection group and palliative resection group were 100%, 76.4% and 45.7% or 57.2%, 22.8% and 0, respectively. The difference between the two groups was statistically significant （P〈0.05）. Conclusion： The patients who receive Billroth Ⅱ subtotal gastrectomy are more susceptible to gastric remnant carcinom, especially in more than 10 years. Endoscopy and gastric biopsy is the primany means to diagnose gastric remnant carcinoma. A regular basis gastroscopy review of patients with subtotal gastrectomy is the primary method of early diagnosis on gastric remnant carcinoma. Radical surgery can improve the survival rate of patients.