胃窦癌根治切除后残胃断端再发癌再切除7例报告  

Re-removal of recurrent cancer on the stump of stomach after radical operation for carcinoma of gastric antrum (A report of 7 cases)

作　　者：孙振华[1] 秦华东[1] 张建国[1] 果永海[1] 

机构地区：[1]哈尔滨医科大学附属第二医院普通外科,150086

出　　处：《中华胃肠外科杂志》2002年第1期35-36,共2页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨胃窦癌根治切除后残胃断端再发癌的诊断和治疗。方法对1980～1995年间经手术和病理证实的7例残胃断端再发癌的临床资料进行回顾性分析。结果首次手术均为根治性远端胃大部切除术(BillrothⅠ式2例,BillrothⅡ式5例)。首次手术到残胃断端再发癌诊断平均间隔时间46.1个月(25～66个月)。再手术均为残胃全切,其中6例合并远侧胰、脾、横结肠和(或)部分肝切除。1例于术后1个月内死于心肌梗死。术后1、3年生存率分别为71.4%和28.6%。结论早期诊断,严格掌握手术适应证,合理的手术切除范围是影响残胃断端再发癌疗效的重要因素。Objective To investigate the diagnosis and the treatment of recurrent cancer on the stump of stomach after radical operation for carcinoma of gastric antrum.Methods Data of 7 above cases were analyzed retrospectively. The diagnosis of these patients was confirmed by surgical operation and pathological examination. Results The first operation of all the patients was radical distal subtotal gastrectomy (Billroth Ⅰin 2 cases, Billroth Ⅱin 5 cases). The mean period from first operation to the diagnosis of recurrent cancer on the stump of stomach was 46. 1 months (25～66 months). Total resection of residual stomach was carried out in all the patients. Operations for six of them included resection of distal pancreas, spleen, transverse colon and / or a part of liver. 0ne of the patients died of myocardial infarction within one month after operation. The survival rates of 1 and 3 year after operation were 71.4%and 28.6%respectively.Conclusion Early diagnosis, strict selection of operative indications and rational removal extent are the key points which will influence the therapeutic effectiveness of recurrent cancer on the stump of stomach.

关 键 词：胃窦癌 外科手术 残胃断端再发癌 再切除 

分 类 号：R735.2[医药卫生—肿瘤]