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目的 本文旨在研究残胃再发贲门癌的再手术治疗。本组１４ 例病例均符合（１）第一次因胃癌行下半胃切除；（２）第二次手术证实原吻合口无复发灶。方法 术前根据Ｘ光钡餐检查，Ｂ超、ＣＴ和纤维胃镜对病灶切除率和切除范围进行术前评估，以减少开胸探查率；估计须作全胃切除或首次行毕氏Ⅱ式者以胸腹联合切口为好，其余可作左胸切口；消化道重建的原则是尽量切除瘤体，尽量减少创伤。结果 本组病灶切除率８３％ ，未发生严重并发症及院内死亡。切除者一年生存率为７７％ ，２年为４４％ ，３年为１１％ 。结论 对残胃再发贲门癌只要病人一般情况允许，术前评估正确，仍应积极手术，关键于在早期诊断和早期手术。
Objectives This article aims to investigate the reoperation of recurrent gastric cardia cancer. The 14 cases in this group were consistent with (1) the first half gastrectomy for gastric cancer; (2) the second operation confirmed the original anastomosis without recurrence. Methods Preoperative evaluation was performed according to X-ray barium meal examination, B-ultrasonography, CT and fiberoptic gastroscopy for preoperative evaluation of resection rate and resection range to reduce the rate of open chest exploration; it was estimated that total gastrectomy or first-time Pythia type II should be performed. The thoracoabdominal combined incision is better, and the rest can be used as a left thoracic incision; the principle of the reconstruction of the digestive tract is to remove the tumor as much as possible to minimize the trauma. Results The resection rate of this group was 83%. No serious complications occurred and no hospital death occurred. The one-year survival rate of the resection was 77%, 44% in 2 years and 11% in 3 years. Conclusions For recurrent gastric cancer, as long as the patient’s general condition permits, and the preoperative evaluation is correct, active surgery should be performed. The key lies in early diagnosis and early surgery.