胃癌术后胃镜随诊的临床意义(附986例报告)

Clinical significance of post operative follow up gastroscopy for patients with gastric cancer:a report of 986 cases

目的探讨胃癌（ＧＣ）术后胃镜随诊的临床意义。方法９８６例ＧＣ术后３周至２１年进行胃镜随诊检查，每例检查１～５次。结果检出残胃复发癌７５例，原胃重复癌４例，残胃癌９例，残胃功能性排空障碍１２例，胃管、硅胶管滞留９例。其他非癌性病变包括：吻合口周围炎１８７例，缝线残留９１例，金属钉外露４例，吻合口周围糜烂、溃疡分别为５１例和２２例，炎性息肉３８例，疤痕性狭窄１１例。结论ＧＣ术后胃镜随诊能及时诊治残胃及吻合口癌性及非癌性病变。对提高患者生活质量和延长生存期有较大的临床意义。

Objective To evaluate the clinical significance of postoperative follow up gastroscopy in patients with gastric cancer. Methods Gastroscopy was performed in 986 patients with gastric cancer from 3 weeks to 21 years after operation. Each cases received gastroscopy 1 to 5 times in the follow up period. Results Recurrent cancer was found in 75 cases, multiple primary malignant tumors in 4 cases and gastric stump cancer in 9 cases in the residual stomach. Functional disturbance of emptying after subtotal gastrectomy was found in 12 cases. Retention of gastric tube or silicon tube was found at the anastomotic stoma site in 9 cases. The other non cancerous disorders included gastritis in 187 cases, residual non absorbable sutures in 91 cases, metal staple in 4 cases, erosion in 51 cases, ulcer in 22 cases, polyposis in 38 cases and scar stenosis in 11 cases at anastomotic site. Conclusion Routine postoperative gastroscopy check up(s) is capable of early detecting cancer lesion and other non cancer disorder in residual stomach. It helps increase survival rate and improve quality of life.