贲门癌切除术后残端阳性61例分析

Postoperative analysis of 61 cases of residual cancer in stump

自1975年6月至1989年6月,我院以经左后外侧切口共施行贲门癌切除手术532例。术后标本病理检查发现残端阳性者61例,发生率为11.5%。主要原因是食管及胃的切除长度不够,其次是腺癌的侵袭性生物学行为比鳞癌强。作者建议,采用胸腹联合切口以保证上下切缘与肿瘤的距离至少5cm。如果在术中采用冰冻切片的检查方法来决定切除的长度,残端阳性将被消除。

532 cases of cardia cancer were resected in our hospital from Junuary 1975 to Junuary 1989,61 of which were found to have residual cancer at the margin of resection,accounting for 11.5%.Its major cause lies in the inadequate excision in the length of esophagus and stomach.And another cause is the stronger biologic invasiveness of adenocarcinoma than of squamous cell carcinoma.The authors suggest the employment of pleuroperitoneal incision to ensure at least a 5cm above and below the tumor margin.The performance of frozen section during operation,the suitable length to resect could be decided and wipe out the residual cancer in the stump.