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目的探讨老年人残胃癌的临床病理特征、早期诊断及外科治疗。方法回顾性分析福建医科大学附属第二医院2000～2009年收治60例老年人残胃癌患者的临床病理资料。结果60例老年人残胃癌患者中,男52例,女8例,平均年龄65.9岁;原胃大部切除术距残胃癌确诊间隔时间平均20.3年;原胃大部分切除吻合方式55例为BillrothⅡ式,5例为BillrothⅠ式;病变主要位于贲门、吻合口,以低分化腺癌多见。48例行手术治疗,其中15例行残胃癌根治性切除术。结论残胃癌常见于BillrothⅡ式术后,老年人行胃大部切除术后5年以上应定期胃镜随访,尤其10年以上者更应作为重点监测对象,以期提高早期诊断率及根治性手术切除率。
Objective To investigate the clinicopathological features, early diagnosis and surgical treatment of gastric residual stump cancer in the elderly. Methods The clinical and pathological data of 60 elderly patients with gastric cancer admitted to the Second Affiliated Hospital of Fujian Medical University from 2000 to 2009 were retrospectively analyzed. Results Among the 60 elderly patients with gastric stump cancer, there were 52 males and 8 females, with an average age of 65.9 years. The average interval between the resection of primary gastrectomy and the diagnosis of residual gastric cancer was 20.3 years. Most of the resected anastomoses were BillrothⅡ 5 cases of Billroth Ⅰ type; lesions mainly located in the cardia, anastomotic, with poorly differentiated adenocarcinoma more common. Forty-eight patients underwent radical surgery, of which 15 underwent radical resection of gastric cancer. Conclusion Gastric stump cancer is common in Billroth Ⅱ type. The elderly should be followed up for more than 5 years after partial gastrectomy. In particular, those with more than 10 years should be the key monitoring targets in order to improve the early diagnosis rate and the radical surgical resection rate.