残胃再发贲门癌的再手术治疗

Re-operation of Cardia Cancer accuring after Gastrectomy

目的 本文旨在研究残胃再发贲门癌的再手术治疗。本组１４ 例病例均符合（１）第一次因胃癌行下半胃切除；（２）第二次手术证实原吻合口无复发灶。方法 术前根据Ｘ光钡餐检查，Ｂ超、ＣＴ和纤维胃镜对病灶切除率和切除范围进行术前评估，以减少开胸探查率；估计须作全胃切除或首次行毕氏Ⅱ式者以胸腹联合切口为好，其余可作左胸切口；消化道重建的原则是尽量切除瘤体，尽量减少创伤。结果 本组病灶切除率８３％ ，未发生严重并发症及院内死亡。切除者一年生存率为７７％ ，２年为４４％ ，３年为１１％ 。结论 对残胃再发贲门癌只要病人一般情况允许，术前评估正确，仍应积极手术，关键于在早期诊断和早期手术。

? Objective To report the re operation of cardia cancer occuring after gastrectomy.All of 14 cases accorded with:1.first operation was gastrectomy due to stomach cancer,2.there was no recurrent focus on gastro entero junction.Methods To evaluate the resectability rate or resectable size is important,as well as to is correctly choos enterable pass and reconstruction methods of digestive tract.Result The resectebility rate was 83%.There was no serious complication and death in the hospital.The 1 year survival rate was 77%,2 year 44%,3 year 11%.Conclusion If the general conditions of patient are good and preoperation evaluation are correct,the operation shoud be performed actively.The early diagnosis and treatment are strongly recommended. 〔