残胃癌66例外科诊治分析

Diagnosis and surgical treatment of 66 cases with gastric stump carcinoma

目的:探讨残胃癌(GSC)的外科疗效及预后。方法:回顾性分析我院和西安交通大学第一附属医院2006年5月-2012年5月收治的GSC患者的临床资料和手术方式。结果:本组66例GSC患者病理类型:低分化腺癌36例,高、中分化腺癌30例。TNM分期:Ⅰ期5例,Ⅱ期8例,Ⅲa期29例,Ⅲb期11例,Ⅳ期13例。全组患者1、3和5年生存率分别为86.36%、51.51%和15.15%。其中42例进行根治性切除包括联合脏器根治切除的患者1、3和5年生存率分别为97.62%、66.67%和21.43%;24例进行姑息性切除的患者1、3和5年生存率分别为66.67%、25.00%和4.17%。脏器根治切除组和姑息性切除组间的1、3和5年生存率差异有统计学意义(P<0.05)。结论:残胃癌一旦确诊应积极手术,根据病情确定合理的手术方案可提高GSC患者的存活率。

[ Abstract] Objective：To investigate the surgical treatment and prognosis of gastric stump carcinoma （GSC）. Methods：. The clinic data of GSC from may 2006 to may 2012 in our hospital and department of oncology of the First Affiliated Hospital,Xihn Jiaotong University School of Medicine were analysed retrospectively. Results：All patients including 36 cases of 10w differentiation adenocarcinoma and 30 cases of high and moderately differentiation adenocarcinoma according to TNM there .were 5,8,29,11,13 cases respectively inⅠ,Ⅱ,Ⅲa,Ⅲb,Ⅳ stage. The survival rates of 1,3,5 years were 86.36% ,51.51%, 15.15% respectively, those of 42 combined organ.radical resection and 24 cases palliative resection 1,3,5 years were 97.62% ,66.67% ,21.43% and 66.67% ,25.00% ,4.17% respectively. The difference between combined organ radical resection and palliative resection group showed statistic significance （ P 〈 0.05 ）. Conclusion： Gastric stump carcinoma once diagnosed should take actively operation. The reasona- ble operation method could improve the survival rate of gastric stump carcinoma.