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本文报告全胃切除术治疗胃癌169例的经验。术后总的1、3和5年生存率分别为70.4％,40.0％和 23.3％。根据本组经验认为高位胃体癌,全胃癌、多原发癌、残胃癌、胃底贲门癌应行全胃切除,术中肉眼判断癌已侵及浆膜层者宜行全胃合并脾胰尾切除。本文改进的空肠原位间置代胃消化道重建术能恢复十二指肠自然通道,具有代胃,又能防止返流性食管炎,倾倒综合征,提高术后生存质量的优点,值得推广应用。
This article reports the experience of total gastrectomy for 169 cases of gastric cancer. The overall 1-, 3-, and 5-year survival rates after surgery were 70.4%, 40.0%, and 23.3%, respectively. According to the experience of this group, high gastric cancer, total gastric cancer, multiple primary cancers, residual gastric cancer, and gastric cardia cancer should be performed with total gastrectomy. Intraoperative judgment of cancer invading the serosal layer should be performed with total stomach combined with spleen and pancreas. Tail resection. The improved jejunum in situ replacement of the stomach and digestive tract can restore the duodenal natural channels, it can replace the stomach, prevent reflux esophagitis and dumping syndrome, and improve the postoperative quality of life. It is worth promoting. application.