42例残胃癌临床诊治分析

Clinical diagnosis and treatment of 42 cases of gastric stump cancer

目的:探讨42例残胃癌临床诊治。方法:回顾性分析2000年1月～2007年10月我院收治的残胃癌患者42例的临床资料。结果:本组手术病例手术均顺利完成,住院期间无一例死亡。全部病例均随访3～5年,行全残胃切除术22例,生存3年者18例,生存5年以上者11例,5年生存率为50.00%。行部分残胃切除术8例,生存3年者4例,生存5年以上者1例,5年生存率为12.50%。采取保守治疗12例在3～11个月(平均6.5个月)内死亡。结论:胃十二指肠良性病变胃大部切除后应高度重视残胃癌发生,特别是采取BillrothⅡ式胃大部切除术患者更应引起高度重视。对残胃患者进行必要的胃镜检查,5年内应每两年行一次胃镜复查,术后大于10年需要每年进行一次。对于有症状异常改变的也建议胃镜检查;若发现病变,能手术者则首选手术治疗。

Objective：To investigate the diagnosis and treatment of 42 cases of patients with gastric stump cancer.Methods：From January 2000 to October 2007 in our hospital,the data of 42 patients with gastric stump cancer were retrospectively analyzed.Results：The cases of surgical operations were successfully completed,no death during hospitalization.All patients were followed up for 3-5 years,with total remnant gastrectomy in 22 cases,18 cases of survival 3 years,survival 5 years in 11 cases,5-year survival rate was 50.00%.Line part of the remnant stomach resection in 8 cases,4 cases of sur-vival 3 years,survival 5 years in 1 case,5-year survival rate was 12.50%.Conservative treatment of 12 cases of death in 3-11 months（6.5 months） died.Conclusion：Benign lesions of stomach and duodenum after gastrectomy remnant gastric cancer should be high priority,especially to most of Billroth Ⅱ gastrojejunostomy resection should be attention.Residual gastric endoscopy in patients with the necessary 5 years should be reviewed every two rows a gastroscope,after more than 10 years required once a year.For symptoms of abnormal changes also recommend gastroscopy;if the disease be detected,it is prior to chose surgery.