手术切除治疗局部复发性胃恶性肿瘤

Resection of local recurrence of gastric malignancy tumor

目的 探讨复发性胃恶性肿瘤手术切除的可能性及临床价值 ,寻求对复发性胃恶性肿瘤治疗的有效方案。方法 回顾性分析 18例成功切除的局部区域性复发胃恶性肿瘤的临床资料。结果 18例切除的复发性胃恶性肿瘤中 ,采用全胃加淋巴清扫 6例 ,胰体尾及脾切除加淋巴清扫 5例 ,胃床部复发肿块切除 2例 ,腹腔干周围肿块切除加淋巴清扫 5例。病理结果证实胃腺癌 14例、胃肉瘤 4例。术后均痊愈出院。随诊结果显示 ,对复发性胃恶性肿瘤再切除可获得平均 16.4(7～ 3 8)个月生存期。结论 局部区域性复发病例如能手术切除 ,并辅以术中、术后灌注化疗及全身化疗等措施 。

Objective To determine the resectability of recurrent gastric malignant tumor and its clinical value, and to search an effective way to cure recurrent gastric malignant tumor. Methods The clinical data of 18 cases of sucessfully resected local regional recurrent gastric malignant tumor were analysed retropectively. Results In the 18 cases of recurrent malignant gastric tumor, 6 received total gastrectomy and lymphadenectomy, 5 received body and tail pancreatectomy plus splenectomy with lymphadenectomy, 2 got tumor resection in gastric bed, and the other 5 got periceliac tumor resection with lymphadenectomy. Pathology evidence revealed that 14 of them were gastric adenocarcinoma and the other 4 were gastric sarcoma. They were all recovered and got well when discharged. Follow up results revealed that resection of recurrent malignant gastric tumor could survive 16.4 months (7～38 months) averagely.Conclusions Patient's life quality and survival time could be improved if the local regional recurrence was resectable and other subsidiary therapeutic methods were used.