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目的 探讨胃癌外科治疗的现状。方法 对我院 2002 年 5 月~2004 年 7 月收治并手术治疗的胃癌 110 例的临床资料进行回顾性分析。结果 110 例胃癌中,手术切除 101 例(91 .82%),其中根治性切除91例,姑息性切除10 例;远侧胃切除 78 例(77 .23%),近侧胃切除 7 例(6 .93%),全胃切除16例(15 .84%);行消化道重建的 104 例中,手法吻合 13 例(12 5%),单吻合器67例(66. 42%),双吻合器 24 例(23. 08%)。术后病理早期癌 9 例(8. 18%),进展期胃癌共 101 例(91 .82%)。术前肠外营养支持5~7天14例(12. 73%),术后行肠道营养86 例(85 15%),肠外营养90例(89 .11%)。手术死亡1例(0 .9%),12例发生术后近期并发症(9. 09%)。结论 胃癌患者早期诊断仍困难,但手术切除率及根治性切除率较以前明显升高,吻合器使用明显增加,有助于降低近期并发症发生率并提高肿瘤治疗的效果。需长时间营养支持时肠内营养较肠外营养更容易维持内环境稳定。
Objective To investigate the status of surgical treatment of gastric cancer. Methods The clinical data of 110 patients with gastric cancer admitted to our hospital from May 2002 to July 2004 were retrospectively analyzed. Results Of the 110 cases of gastric cancer, 101 cases (91.82%) were resected surgically, of whom 91 cases were radical resection and 10 cases were treated by palliative resection; 78 cases were distal gastrectomy (77.23%), 7 cases were proximal gastrectomy 16 cases (15.84%) underwent total gastrectomy, and 13 cases (12.5%) were treated by manual operation, 67 cases (66.42%) were single staplers, 24 cases of stapling (23. 08%). There were 9 cases (8.18%) of early postoperative pathology and 101 cases (91.82%) of advanced gastric cancer. Preoperative parenteral nutrition support 14 cases (12.73%) 5 to 7 days, postoperative enteral nutrition 86 cases (85 15%), parenteral nutrition 90 cases (89.11%). 1 case (0.9%) died of surgery, and 12 cases had immediate postoperative complications (9.09%). Conclusion The early diagnosis of gastric cancer is still difficult, but the resection rate and radical resection rate was significantly higher than before, the use of stapler significantly increased, which will help reduce the incidence of recent complications and improve the efficacy of cancer treatment. Enteral nutrition is more easily maintained than parenteral nutrition when long-term nutritional support is required.