复发性胃癌患者再手术的治疗价值

Value of reoperation in the treatment of recurrent gastric cancer

目的 探讨复发性胃癌再手术治疗的临床意义.方法 回顾性分析1986年1月至2003年12月收治的85例复发性胃癌再次手术病例的临床资料及生存资料.结果 本组85例中,复发局限于残胃46例,复发时间＜2年58例.全组再手术切除45例,其中根治性切除34例,姑息性残胃切除11例,联合行脏器切除19例.根治性残胃切除术后的1、3、5年生存率分别为86%、57%和21%,中位生存期56个月;姑息性手术及其他综合治疗者的生存时间为6～26个月,中位生存期16个月;未切除患者均于半年内死亡.结论 术后定期复查有助于复发性胃癌的早期诊断和治疗,复发性胃癌以残胃复发多见,具有较高切除率,应积极再手术治疗.

Objective To determine the value of reoperation in the treatment of recurrent gastric cancer. Methods Clinical and survival data of 85 patients undergoing reoperation for recurrent gastric cancer from January 1986 to December 2003 were studied retrospectively. Results Among 85 cases, there were 46 cases with recurrence within the stump stomach and 58 cases recurred within 2 years post-operation.Resection was performed in 45 patients including 34 cases treated by radical resection and 11 cases by palliative residual stomach resection. The 1, 3, 5-year survival rate of 34 cases after radical resection was 86%, 57% and 21% respectively. The mean survival time of palliative and comprehensive treatment cases was 16 months （range： 6-26） while all patients undergoing reoperation without resection died within 6 months post-operation. Conclusion An early diagnosis of recurrent gastric cancer depends on frequent reexaminations. Most postoperative recurrent gastric cancers, within the residual stomach, may be treated by re-operation.