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目的 探讨胃癌切除术切端癌残留的原因及预防手段，以减少癌残留的发生。方法 对我院１９８８ 年１ 月至１９９３ 年４ 月胃癌切除术切端癌残留３２ 例进行回顾性分析。结果 胃癌切除术切端癌残留率为７ ．５ ％ （３２／４２８） ，其中近端癌残留１１ 例，远端癌残留１７ 例，近远端均有癌残留４ 例。根治性胃癌切除术癌残留率为５ ．５ ％ （１７／３０９） ，姑息性胃癌切除术癌残留率为１２ ．６ ％ （１５／１１９） ，两者比较差异有显著性意义（ Ｐ＜ ０ ．０５） 。远、近端胃切除术切端癌残留率分别为５ ．９ ％ 及１３ ．０ ％ ，两者间差异也有显著性意义（ Ｐ＜ ０ ．０５） 。癌残留与癌肿的大体类型、大小、分化程度及浸润深度有关（ Ｐ＜ ０ ．０５） 。结论 浅表广泛型早癌，弥漫浸润型进展癌，癌肿直径＞ ５ ｃｍ ，分化程度低或不良，以及癌肿浸破浆膜者，易发生癌残留。警惕切端癌残留，术中重视切端冰冻活检，有助于减少胃癌切除术切端癌残留的发生率。
Objective To investigate the reasons and precautionary measures of resectable end-cancer in gastric resection to reduce the occurrence of cancer residual. Methods A retrospective analysis was performed on 32 cases of resected end-cancer in gastric resection from January 1988 to April 1993 in our hospital. Results The residual rate of endoscopic resection of gastric cancer was 7. 5% (32/428). There were 11 cases of proximal cancer and 17 cases of distal cancer. There were 4 cases of cancer residues in the proximal and distal end. Radical gastric resection cancer residual rate of 5. 5% (17/309), palliative resection of gastric cancer residual rate of 12. 6% (15/119), the difference between the two was significant (P <0 .05). Far and proximal gastrectomy residual cancer rates were 5. 9% and 13. 0%, the difference was also significant (P <0 .05). Carcinoma residues and the general type of cancer, size, degree of differentiation and depth of invasion (P <0 .05). Conclusions Superficial broad-spectrum precancerous and diffuse infiltrative advanced cancers with a diameter of> 5 cm, poorly differentiated or poorly differentiated tumors, and cancerous infiltrating serosa are prone to cancer residues. Be wary of cutting end of residual cancer, intraoperative frozen-biopsy cut ends, help to reduce the incidence of residual gastric cancer resection.