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目的探讨残胃癌的早期诊断和治疗方法。方法26例患者术前均行胃镜组织活检及上消化道钡餐检查;26例均行手术治疗。根治性切除13例,包括残胃全切除+胰体尾+脾2例,残胃全切除5例,残胃远端胃大部切除6例;姑息性切除7例;因吻合口处肿块巨大不能切除仅行输出袢短路吻合术加空肠造瘘术4例;因腹腔内广泛转移仅行肿块活检术2例。结果胃镜组织活检对残胃癌的诊断率明显高于上消化道钡餐;行根治性残胃切除的手术效果明显高于其他手术方式。结论胃镜组织活检是残胃癌早期诊断的重要手段.根治性残胃切除是早期残胃癌首选的治疗方法。胃镜对残胃癌的诊断价值优于钡餐。早期诊断并行根治性残胃切除患者预后较好。
Objective To investigate the early diagnosis and treatment of residual gastric cancer. Methods Twenty-six patients underwent gastroscopy biopsy and upper digestive tract barium meal preoperatively. Twenty-six patients underwent surgery. Radical resection in 13 cases, including residual gastric resection + pancreatic body tail + spleen in 2 cases, 5 cases of residual gastric total resection, gastric remnant distal gastrectomy in 6 cases; palliative resection in 7 cases; due to anastomotic mass Can not be removed only line output 袢 short circuit anastomosis plus jejunal fistula in 4 cases; extensive metastasis due to intra-abdominal mass biopsy in only 2 cases. Results The diagnostic rate of endoscopic gastric biopsy was significantly higher than that of the upper gastrointestinal barium meal. The curative effect of radical gastrectomy was significantly higher than other surgical methods. Conclusion Gastroscopic biopsy is an important method for the early diagnosis of residual gastric cancer, and radical residual gastric resection is the preferred treatment for early residual gastric cancer. Endoscopy diagnosis of residual gastric cancer is better than barium meal. Early diagnosis of radical stump resection patients with good prognosis.