37例残胃癌患者外科治疗的预后分析

Survival analysis of gastric stump cancer:a report of 37 cases

目的探讨外科手术对残胃癌患者预后的影响。方法回顾性分析我院1993年1月至2003年3月收治的残胃癌患者的临床资料,按胃镜检查分期和外科手术方式进行分组,采用Kaplan-Meier方法绘制生存曲线,进行累积生存率的比较。结果37例残胃癌患者中,早期残胃癌9例(24.3%),进展期残胃癌28例(75.7%),两者根治术后累积5年生存率分别为55.3%和16.5%(P<0.01)。残胃癌根治性切除21例(56.8%),与姑息性手术组相比,两者中位生存时间分别为40.3和13.0个月,生存分析显示,差异具有显著性意义(P<0.01)。结论定期胃镜复查和合理的根治手术是提高残胃癌患者生存率的有效方法。

Objective To study the effect of surgical treatment on the prognosis of gastric stump cancer patients. Methods From Jan. 1993 to 2003 March, 37 patients with gastric stump cancer received surgical operation in our hospital. The patients were divided into early stage and advanced groups,radical and palliative groups respectively. Clinical data and survival were analyzed retrospectively. Results There were 9(24.3%) early cases and 28(75.7%) cases with advanced stump cancer. The postoperative cumulative 5 year survival rate of the patients with early staged gastric stump cancer was significantly higher than those with advanced cancer (55.3%vs 16.5%,P< 0.01). Twenty one (56.8%) patients received radical resection. The median survival time was 40.3 months in radical group and 13.0 months in palliative group(P< 0.01). Conclusions It is necessary to carry out the periodic endoscopic examination in the patients who have received gastrectomy for benign gastric diseases. The reasonable radical resection is an effective way to prolong the postoperative survival time in gastric stump cancer.