胃癌急性穿孔的诊断和处理

DIAGNOSIS AND MANAGMENT OF ACUTE PERFORATED GASTRIC CANCER

本文报道经手术及病理证实的胃癌急性穿孔22例,分别占同期胃急性穿孔和胃癌的20.4％(22/108)和5.1％(22/431)。患者平均年龄58岁,50岁以上者占81.8％。胃癌急性穿孔易与溃疡病穿孔混淆,本组术前误诊72.7％,术中误诊40.0％。作者强调术中判断,并常规取活检以减少误诊率;对能切除的肿瘤应力争一期切除,无一期切除条件者亦应在修补穿孔后2～3周内再手术。

This paper reported 22 cases with acute petforated gastric cancer (APGC) verified operationally and pathologically. It was respectively 20.4% in acute gastric perforation and 5.1% in the cases wich gastric cancer homochronously. APGC is easly misdiagnosed as perforated as perforated peptic ulcers with 72.7% and 40.0% misdlagnosis preop eratively and operatively in this series. The ratio of tumor resection was 45%. Authors discussed the diagnosis before and during operation and emphasized that a careful distinguish and rule biopsy in operstion, furthermore, a primary resection or reoperation by 2-3 weeks after repair should be trived for if the tumor can be removed.