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本文分析了我院1973年10月～1986年8月施行全胃切除的73例胃癌患者的临床资料、手术、病理检查及手术并发症等。术后近期死亡5例,手术病死率6.8%。随访58例(86%),术后1、3、5年的生存率分别为50%、34%和22%。半数以上患者术后有不同程度的碱性反流性食管炎症状。指出患者的年龄大小、病期长短及组织类型对预后的影响不大,但癌肿的浸润程度尤其是胃壁浆膜层的浸润、淋巴结的转移范围、全胃切除同时采用不适当的联合脏器切除、术后吻合口瘘(10.8%)、感染等并发症及营养不良、恶液质等是影响预后的主要因素。
This article analyzed the clinical data, surgery, pathological examination and surgical complications of 73 patients with gastric cancer who underwent total gastrectomy in our hospital from October 1973 to August 1986. Five patients died recently after surgery, and the mortality rate was 6.8%. Fifty-eight (86%) patients were followed up. The survival rates at 1, 3, and 5 years after surgery were 50%, 34%, and 22%, respectively. More than half of patients had varying degrees of alkaline reflux esophagitis symptoms. It was pointed out that the patient’s age, length of disease, and tissue type had little influence on the prognosis, but the degree of invasion of the cancer was especially the infiltration of the gastric mucosal serosa, the extent of lymph node metastasis, and the use of inappropriate joint organs for total gastrectomy. Resection, postoperative anastomotic leakage (10.8%), infection and other complications and malnutrition, dyscrasia are the main factors affecting the prognosis.