老年人残胃癌临床病理特征与诊治

目的探讨老年人残胃癌的临床病理特征、早期诊断及外科治疗。方法回顾性分析福建医科大学附属第二医院2000～2009年收治60例老年人残胃癌患者的临床病理资料。结果60例老年人残胃癌患者中,男52例,女8例,平均年龄65.9岁;原胃大部切除术距残胃癌确诊间隔时间平均20.3年;原胃大部分切除吻合方式55例为BillrothⅡ式,5例为BillrothⅠ式;病变主要位于贲门、吻合口,以低分化腺癌多见。48例行手术治疗,其中15例行残胃癌根治性切除术。结论残胃癌常见于BillrothⅡ式术后,老年人行胃大部切除术后5年以上应定期胃镜随访,尤其10年以上者更应作为重点监测对象,以期提高早期诊断率及根治性手术切除率。

Clinicopathological features and surgical treatment of remnant gastric carcinoma in old fuman

Objective To study clinicopathological features,early diagnosis and rational surgical treatment of remnant gastric carcinoma in old fuman.MethodsThe clinicopathological data of 60 cases with remnant gastric carcinoma in old fuman in our hospital from 2000 to 2009 were analyzed retrospectively.ResultsIn 60cases,there are 52 male cases,8 female cases.The average age was 65.9 years,The time from first operation to onset is 10~50 years,with an average of 20.3 years.57 cases were received BillrothⅡ anastomosis,and only 3 cases were received Billroth Ⅰ anastomosis.The leision mostly lies near cardiac and anastomotic stom.The pathological type of remnant gastric carcinoma is mostly low differentiated adenocarlaoma.48 cases underwent operation,in which 15 cases underwent radical operation.ConclusionThe remnant gastric carcinoma in old fuman after Billroth II anastomosis is higher than that of Billroth I type.In order to elevate early diagnosis rate and radical operation rate,it is necessary for the patients of old fuman with benign gastric diseases who received partial gastrectomy beyond 5 years to carry out the gastroscopy follow-up,especially in patients with Billroth Ⅱ reconstruction procedure after 10 years.