胃癌切除术切端癌残留临床分析  

Characteristics and prevention of positive stump in gastrectomy for gastric carcinoma

作　　者：胡建昆[1] 陈志新[1] 陈佳平[1] 彭德恕[1] 陈咏梅[1] 

机构地区：[1]华西医科大学附属第一医院普外科

出　　处：《中国胃肠外科杂志》1999年第1期41-43,共3页

摘　　要：目的探讨胃癌切除术切端癌残留的原因及预防手段，减少癌残留的发生。方法回顾性分析我院１９８８年１月至１９９３年４月胃癌切除术切端癌残留３２例。结果胃癌切除术切端癌残留率７．４７％。上切端癌残留１１例，下切端癌残留１７例，上下端均有癌残留４例。根治性胃癌切除术癌残留率５．５％，姑息性胃癌切除术癌残留率１２．６１％，二者经统计学检验有显著差异。远、近端胃切除术切端癌残留率分别为５．８６％及１３．０％，统计学检验二者有显著性差异。癌残留与癌肿的大体类型、大小、分化程度及浸润深度有关（Ｐ＜０．０５）。结论浅表广泛型早癌，弥漫浸润型进展癌，癌肿直径＞５ｃｍ，分化程度低或不良，癌肿侵破浆膜者，易发生癌残留。术中切端冰冻活检，有助于减少胃癌切除术切端癌残留的发生率。Objective To investigate the reason of positive stump in gastrectomy for gastric carcinoma. Method Thirty two cases with positive stump in gastrectomy for gastric carcinoma from 1988 to 1993 in the hospital have been reviewed by retrospective study. Results Positive stump rate (PSR) was 7 47%. the PSR of radical and palliative resection were 5.5% and 12.61%, respectively ( P <0 05). The PSR of distal and proximal gastrectomy were 5.86% and 13.0% respectively ( P <0 05). The PSR was related to gross type, size of cancer, the degree of differentiation and infiltration. Conclusion The PSR was high in the infiltrating type, lesions larger than 5 cm in diameter and undifferentiated cancer. To prevent the positive stump in gastric carcinoma, the frozen biopsy should be done when it is necessary.

关 键 词：胃癌切除术 手术切端癌 肿瘤 病理学 

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