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目的探讨残胃癌患者的临床病理特点,分析有效的外科治疗手段,以期为残胃癌患者带来福音。方法选取我院2005年3月~2013年6月收治的残胃癌患者25例,收集所有患者的临床资料,从临床表现、诊断结果、发生部位、组织学类型以及病理分期这些方面进行回顾性分析。结果手术后1例死于肺部感染,第10天诱发心衰死亡。4例未接受手术治疗,5例只施行剖腹探查术,2例失访之外,都死亡,5例姑息性手术患者中3例术后生存了11个月~1年。11例根除术患者中10例随访,8例死于肿瘤复发转移。生存时间超过5年1例,生存3~5年4例,生存时间少于3年3例,2例存活。结论残胃癌主要出现在Billroth II手术,病变部位则在吻合口。该疾病易出现延迟诊断,患者多表现为腹部疼痛、消化道出血等,根治手术是治疗残胃癌的有效术式。
Objective To investigate the clinicopathological characteristics of patients with gastric residual gastric cancer and to analyze the effective surgical treatment in order to bring good news for the patients with gastric residual gastric cancer. Methods Twenty-five patients with gastric residual cancer were selected from March 2005 to June 2013 in our hospital. The clinical data of all patients were collected and analyzed retrospectively from the aspects of clinical manifestations, diagnosis, location, histological type and pathological stage . Results One patient died of pulmonary infection after operation and died of heart failure on the 10th day. 4 had no surgery, 5 had laparotomy only, and 2 had lost their follow-up. Three of 5 patients undergoing palliative surgery survived for 11 months to 1 year. Of the 11 patients who underwent radical operation, 10 were followed up and 8 died of tumor recurrence and metastasis. Survival time of more than 5 years in 1 case, survival of 3 to 5 years in 4 cases, survival time of less than 3 years in 3 cases, 2 cases survived. Conclusion Stomach cancer mainly occurs in Billroth II operation, and the lesion is in anastomotic site. The disease is prone to delay diagnosis, patients with abdominal pain, gastrointestinal bleeding, radical surgery is an effective treatment of residual gastric cancer surgery.