残胃癌18例诊治分析

我院自1982年1月至1995年1月收治经手术和病理证实的残胃癌18例,占同期收治胃癌的2.06％,其中男14例,女4例,年龄自43岁～78岁,平均58.3岁。发生残胃癌的时间自胃切除术后10年—25年,平均15.6年。再次手术切除12例,切除率为66.6％,其中根治切除5例,占27.7％,6例因病变广泛固定,仅行探查活检和腹腔置管化疗。严格胃切除指征,降低残胃基数和尽量采用毕氏Ⅰ式或Roux—y型及间置空肠吻合是目前减少残胃癌发生的有效途径,自胃切术后10年起定期进行胃镜检查,是发现早期残胃癌的可靠方法,早期手术是目前改善残胃癌预后的唯一途径。

Diagnosis and Treatment of 18 Cases of Remnant Stomach Carcinoma

From January 1982 to January 1995,18 cases of remnant stomach carcinoma,proved by operation and pathology, 14 males and 4 females aged 43-78 with a median 58. 3 years were treated in our hospital,being 2. 06% of all the cases of stomach carcinoma treated in the hospital in the same period. The detected time for remnant stomach carcinoma were 10-25 years after'gastrectomy with an .average of 15. 6 years. 12 cases had regactrectomy and the regactrectomy rate was 66. 6% ,out of them radical gastrectomy was performed in 5 cases (27. 7%), surgical exploration with biopsy and intrapentonea intubating chemotherapy was performed in 6 cases because of the extensive unresectable phathologic changes. The effective way to reduce the incidence of remnant stomach carcinoma is to decrease the basic number of remnant stomach and to use Biroth's I type gastroduodenostomy or Roux -y jejunojejunostomy or insertion jejunum anastomosis. The reliable procedures to early recognition of carcinoma are regular and repeated gas-troscopic examination,And early reoperation is the only way to improve the prognosis of the residual stom-acn carcinoma.