复发性胃癌的再次手术治疗  

Reoperation for recurrent gastric carcinoma

作　　者：陈小春[1] 张桂英[2] 潘凯[1] 余小舫[2] 麦沛成[2] 周冬仙[2] 

机构地区：[1]深圳市人民医院暨南大学第二附属医院胃肠外科,518020 [2]深圳市人民医院暨南大学第二附属医院普通外科,518020

出　　处：《中华胃肠外科杂志》2004年第4期286-288,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的评估复发性胃癌再次手术治疗的临床价值。方法回顾性分析我院1990年1月至2003年6月收治的58例复发性胃癌再次手术病例的临床病理及生存资料。结果全组病例多为术后定期胃镜检查发现复发,其中41例发生于2年之内。全组再次手术切除40例,再次手术后第1、3、5年生存率分别为70.7%、29.2%和10.3%;其中相对根治性切除者23例(根治性切除组),平均生存39个月,术后第1、3、5年生存率分别为100%、56.5%和26.1%;姑息性切除者17例(姑息性切除组),平均生存23个月,术后第1、3、5年生存率分别为94.1%、17.6%和0。而未能切除者18例(未切除组)均于1年内死亡。3组术后生存率比较,差异有显著性意义(P<0.01)。结论术后定期纤维胃镜检查有助于复发性胃癌的早期诊断和提高手术切除率。选择身体素质相对较好、复发癌肿较局限的患者采取积极的再次手术治疗,可延长患者生存时间,提高其生活质量。Objective To estimate the clinical value of reoperation for recurrent gastric carcinoma. Methods Clinicopathological and periodical follow-up data of 58 patients undergoing reoperation for recurrent gastric carcinoma from January 1990 to June 2003 were studied retrospectively. Results Forty-one of the patients had recurrence within two years after operation. All recurrences were found by periodic endoscopy. Resection was performed in 40 patients and the overall 1-,3-and 5-year survival rates were 70.7%,29.2%and 10.3%respectively. Twenty-three patients underwent radical resection,and the mean survival time was 39 months, and the 1-,3-and 5-year survival rates were 100%,56.5%and 26.1%respectively. Seventeen patients underwent palliative resection, and the mean survival time was 23 months, and the 1-,3-and 5-year survival rates were 94.1%,17.6%and 0 respectively. All the patients undergoing reoperation with no resection died within one year after operation. The survival rates among three groups were significantly different(P< 0.01). Conclusions Early diagnosis of recurrent gastric carcinoma depends on periodic endoscopy. Reoperation with radical resection can improve the survival and quality of life for the patients in good condition with local recurrent gastric carcinoma.

关 键 词：复发性胃癌 再次手术 外科治疗 手术方式 

分 类 号：R735.2[医药卫生—肿瘤] R730.56[医药卫生—临床医学]