残胃复发癌的再手术治疗  

Reoperation for postoperative recurrent gastric carcinoma

作　　者：邹寿椿[1] 胡智明[1] 张成武[1] 赵大建[1] 陶厚权[1] 赵挺[1] 姜蔚[1] 

机构地区：[1]浙江省人民医院外科,杭州310014

出　　处：《中华普通外科杂志》2004年第9期549-550,共2页Chinese Journal of General Surgery

摘　　要：目的探讨残胃局部复发癌再手术治疗的临床意义。方法回顾性分析我院 1986～2 0 0 1年间收治的 5 1例残胃局部复发癌的临床资料。结果本组 5 1例中 ,复发局限于残胃者 31例 ,伴有转移的复发 2 0例。行根治性切除术 2 7例 ( 5 3% ) ,其中 16例行联合脏器切除术 ;行姑息性残胃全切术 3例 ,胃肠吻合、造口术 15例 ;单纯剖腹探查术 6例。 30例切除术后病理检查报告 :吻合口周围复发 10例 ,残胃复发癌 2 0例。根治性切除组术后 1、3、5年生存率分别为 88%、5 8%、19%。姑息性手术及综合治疗组的生存时间为 6～ 2 4个月 ,中位生存期为 16个月 ;单纯剖腹探查及腹腔化疗组均于 2～ 7个月内死亡。结论残胃局部复发癌以残胃、吻合口局部复发为主 ,具有较高的切除率 。Objective To evaluate the clinical significance of re operation for postoperative recurrent gastric carcinoma. Methods From 1986 to 2001, fifty one patients with postoperative local recurrence of gastric carcinoma were admitted into our hospital. The clinical data were analyzed retrospectively. Results Of 51 cases, there were 31 cases with recurrence within the stump stomach and 20 with local and metastatic recurrence. Twenty seven cases were treated by radical resection, 3 cases by palliative residual stomach resection, 15 cases by gastrojejunostomy or gastroenterostomy, 6 cases by simple exploration. Pathological examination of 30 cases revealed perianastomosis recurrence in 10 cases, stump stomach carcinoma in 20 cases. The 1,3,5 year survival rate of 27 cases after radical resection was 88%, 58%, 19% respectively. The survival time of palliative and comprehensive treatment group was 6 to 24 months and mean survival time was 16 months, while all patients undergoing simple exploration and abdominal cavity chemotherapy died after 2 to 7 months. Conclusion Most postoperative recurrent gastric carcinoma are within the residual stomach and hence could be treated by reoperative resection.

关 键 词：残胃复发癌 再手术治疗 局部复发 吻合口 姑息性手术 造口术 切除率 切除术后 联合脏器切除术 中位生存期 

分 类 号：R735.2[医药卫生—肿瘤]