胃大部分切除术后残胃癌19例临床分析

Gastric remnant cancer developed after subtotal gastrectomy:a report of 19 cases

目的 探讨残胃癌的早期诊断方法和手术处理方式。方法 对 19例残胃癌的临床病理资料进行回顾性分析 ,比较胃镜和钡餐对残胃癌的诊断价值。观察根据术中探查情况采取不同手术方式对预后的影响。结果 胃镜对残胃癌的诊断率为 78.9% ,钡餐为 47.4%。手术切除的 8例中根治性残胃切除 5例均存活≥ 3年 ;姑息性切除的 3例 ,术后存活 2年 2例 ,18个月 1例。行胃空肠吻合 6例中 4例于 6个月内死亡 ,2例分别存活 12 .5个月和 14个月。 5例腹腔内广泛转移者仅行肿块活检术。结论 胃镜对残胃癌的诊断价值优于钡餐。根治性残胃切除患者预后较好。

Objective To investigate the earlier diagnostic methods and operative procedures of gastric remnant cancer. Methods Clinicopathologic data of 19 cases of gastric remnant cancer were retrospectively analysed,and the diagnostic value of the gastroscopy and barium meal was compared.Influencing the prognosis of gastric remnant cancer treated by different operations according to the situation seen during operation were observed. Results The diagnostic rate of gastroscopy and barium meal was 78.9% and 47.4%, respectively.All the 5 cases who underwent radical remnant gastrectomy sarvived≥3 years postoperatively.Two of the 3 cases who underwent palliative remnant gastrectomy survived 2 years and 1 alived 1.5 years postoperatively. In 6 cases of gastrojejunostomy, 4 cases died within half year, 2 cases died 12.5 and 14 months postoperatively. Conclusions The diagnostic value of gastroscopy takes advantage over barium meal examination. The patients who treated by radical remnant gastrectomy have better prognosis.