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目前对早期与进行期胃癌施行根治手术尚存在一定的争论问题。合理地选择根治术式是提高疗效的关键。本文根据我室既往对早期胃癌60例,进行期胃癌401例,以及最近按“规约”施行根治Ⅱ式(R_2)、根治Ⅲ式(R_3)155例胃癌手术的研究资料,对合理根治术进行探讨。施行合理根治手术的前提是必须掌握不同进展程度胃癌的手术适应证。近年来各种声像等新检查法的应用,能比较准确地发现原发灶与转移病灶的范围,有利于施行合理的根治术。由于胃癌的病期、类型不同,转移扩散的特点与程度也不相同,而且每个病例的病变特点也有差异,所以术式的选择不可能按单一条件决定,而应全面考虑。我院按以下四个条件决定术式。1.胃癌在胃壁内向口、肛侧端浸润程度。特别是进行期贲门癌或胃上部癌向食管粘膜;幽门窦癌向
At present, there are still some controversies about the radical surgery for early and advanced gastric cancer. Rational selection of radical surgery is the key to improving efficacy. In this paper, based on previous studies in our department on 60 cases of early gastric cancer, 401 cases of progressive gastric cancer, and recently performed “Rational type II (R_2) and radical type III (R_3) 155 cases of gastric cancer surgery according to the ”Statute", the rational radical surgery was performed. Explore. The premise of reasonable radical surgery is the necessity to grasp the surgical indications of different degrees of progression of gastric cancer. In recent years, the application of various new methods such as audio-visual imaging can more accurately detect the extent of primary lesions and metastatic lesions and facilitate the implementation of rational radical surgery. Due to the different stages and types of gastric cancer, the characteristics and extent of metastatic spread are not the same, and the characteristics of lesions in each case are also different. Therefore, the choice of surgical technique cannot be determined by a single condition, but should be fully considered. Our hospital decided on the following four conditions. 1. Gastric cancer in the stomach wall to the mouth, anal end infiltration. In particular, the stage of cardial cancer or upper stomach cancer to esophageal mucosa; pyloric sinus cancer