胃癌术后复发再手术治疗(附27例报告)

 目的 探讨胃癌术后复发的临床特点及再手术的适应症。方法 回顾性分析1998-2003年胃癌术后复发进行再手术治疗的27例临床资料，并对手术方法、术后并发症、病死率及术后病理结果进行分析。结果 术中探查发现18例侵及毗邻脏器，淋巴结转移9例，术后生存5年以上7例，3年以上10例，1年以上16例，1年内死亡11例。单纯探查6例分别于1～6月内死亡。结论 复发性残胃癌以侵及邻近脏器为特点，其淋巴结主要在第1、3、11、12、13、15组及原吻合部位空肠系膜内淋巴结（未分组）。对复发性残胃癌即使侵及邻近脏器，无远处多发转移，均应争取再次手术，提高疗效。

The Surgical Therapy Experience of 27 Cases of Recurrent Gastric Cancer

Objective 　To discuss the clinical characteristics of recurrent gastric cancer and indications of reoperation. Methods 　Retrospective analysis of 27 patients undergoing reoperation for recurrent gastric carcinoma from 1998 to 2003 was made in terms of operative methods ,postoperative complications , death rate and postoperative pathological characteristics. Results 　Adjacent organs were encroached of 18 cases in operation exploration , lymphoid nodes metastasis were observed in 9 patients , 7 cases survived over 5 years , 10 over 3 years ,16 over 1 years , and 11 cases died in 1 year. 6 cases died 1～6 months after operation were showed in simple exploratory survey. Conclusion 　The feature of recurrence gast ric cancer is invasion of adjacent organ. The lymph nodes were lied mainly in 1 、3 、11 、12 、13 、15 groups and endomesojejunum lymph nodes on primary anastomotic site ( ungrouping) . Those cases who suffered from recurrences of gastric carcinoma with invasion of adjacent organ but without distant multiple transfer can undergo a second operation to improve therapeutic effect .