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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 treatment of recurrence of residual gastric stump after radical resection of gastric cancer. Methods The clinical data of 7 patients with recurrent stump gastric cancer confirmed by operation and pathology from 1980 to 1995 were analyzed retrospectively. Results The first operation was radical radical gastrectomy (Billroth Ⅰ 2 cases, Billroth Ⅱ 5 cases). The average time between the first surgery and the reoperation of residual stump was 46.1 months (25-66 months). Re-operation were residual gastrectomy, including 6 cases of distal pancreas, spleen, transverse colon and (or) partial hepatectomy. One patient died of myocardial infarction within 1 month after operation. The 1-year and 3-year survival rates were 71.4% and 28.6% respectively. Conclusion Early diagnosis, strict indications of surgical indications, a reasonable range of surgical resection is an important factor that affects the efficacy of residual stump end resection of cancer.