胃癌肝转移31例外科治疗体会  

Surgical treatment of 31 cases of hepatic metastatic tumor from gastric carcinoma

作　　者：陈胜林[1] 王兵[1] 余水平[1] 汪栋宇[1] 莫伟民[1] 

机构地区：[1]湖北省黄石市第二医院普外科,435002

出　　处：《腹部外科》2007年第2期97-98,共2页Journal of Abdominal Surgery

摘　　要：目的探讨胃癌肝转移的外科治疗效果。方法对我院1997年10月～2006年10月收治的原发性胃癌338例中伴肝转移的31例的临床资料进行回顾性分析。对其中施行同时性胃癌肝转移灶切除术(切除组)的19例和仅行胃癌根治术而未行肝转移灶切除术(未切除组)的12例的术后生存时间进行对比。结果全组除1例术后死于肝功能衰竭外,其余30例均获得随访。胃癌肝转移灶切除术后1年、3年和5年生存率分别为83.3%、44.4%和33.3%;未切除组术后1年生存率为50.0%,3年及5年生存率为0。两组术后生存时间有显著性差异(P<0.05)。切除组病例中有68.4%在肿瘤和周围肝组织间形成纤维假膜。结论假包膜形成是有利的预后因素。对于胃癌肝转移病人,特别是有假包膜形成者采用外科治疗预后更好。Objective To investigate the effectiveness of surgical treatment of hepatic metastatic tumor from gastric carcinoma. Methods Clinical data of 31 cases of hepatic metastatic tumor out of 338 patients with primary gastric cancer from October 1997 to October 2006 were analyzed retrospectively. A comparative study was done on 19 cases（resection group）undergoing hepatectomy ＋ gastric cancer radical operation vs 12 cases（non-resection group）only receiving gastric cancer radical operation in the postoperative survival time. Results One case died of liver function failure after operation and the remaining 30 cases were followed up. After resection of hepatic metastastic loci from gastric carcinoma, the 1-,3- and 5-year survival rate was 83. 3 %,44. 4% and 33. 3% respectively, and in the non- resection group, that was 50. 0 %, 0 and 0 respectively. There was significnat difference in the postoper- ative survival time between two groups （P〈0. 05）. In resection group, fibrous pseudomembrane between tumor and liver tissues was formed in 68. 4% patients. Conclusion The fibrous pseudomembrane is the advantageous prognostic factor. For the patients with hepatic metastatic locl from gastric carcinoma, especially for those with fibrous pseudomembrane, better prognosis can be obtained by surgical treatment.

关 键 词：胃肿瘤 肿瘤转移 肝外科手术 预后 

分 类 号：R735.2[医药卫生—肿瘤]