胃癌穿孔的外科治疗

Surgical treatment for perforation of gastric carcinoma

目的探讨胃癌穿孔的外科治疗方法。方法对１９８８年１月至１９９８年１月间７４例胃痛穿孔的患者所实施的几种手术方式及其疗效进行回顾分析。结果穿孔修补３０例，姑息性切除２４例，根治性切除２０例。术后并发症发生率６．８％；手术死亡率１．４％。穿孔修补、姑息性切除、根治性切除术后１、３、５年生存率分别为３．３％、０、０；５４．２％、２５．０％、０；７５．０％、５５．０％、２０．０％。结论对于胃癌急性穿孔的病例，采取积极的治疗措施，可望延长患者的生存时间和提高患者的生存质量。

Objective To explore the surgical treatment for perforation of gastric carcinoma. Methods The clinical data of 74 cases with perforation of gastric carcinoma which underwent different surgical procedures from January 1988 to January 1998 were analyzed retrospectively. Results Thirty patients underwent repair of perforation; 24 received partial gastrectomy and 20 radical gastrectomy. Postoperative complication occurrence was 6. 8% and mortality 1. 4%. One-, 3- and 5-year survival rates were 3.3% .0, 0 in repair gastrectomy group; 54.2% , 25.0% .0 in partial group; 75.0% 55. 0% ,20. 0% in radical group. Conclusion Radical gastrectomy and positive treatment can prolong the survival time and improve the quality of life of the patient with perforation of gastric carcinoma.