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报告1985年1月—1994年12月382例胃癌根治性切除术的临床资料。其中贲门胃底癌144例,胃体癌52例,胃窦癌168例,皮革样胃癌和胃内多原发癌13例,残胃癌5例。占同期胃癌手术的69.8％(382/547)。行远端胃大部切除术172例,近端胃大部切除术135例,全胃切除术75例。联合脏器切除术42例。术后获随访329例,随访率86.1％。1、3、5年生存率分别为80.7％、62.9％、50.3％。提出早期胃底贲门癌(I_A期)行近端胃大部切除术;未浸出浆膜层胃底贲门癌(I_B期)5、6组淋巴结无转移者行保留幽门全胃切除间置空肠代胃术,可有效防止返流性食管炎延长食物在代“胃”内停留时间,符合生理;胃窦癌行远端胃大部切除术。浸出浆膜层贲胃底癌,皮革样胃癌、胃体癌、胃内多发癌、残胃癌行根治性全胃切除术。
The clinical data of 382 radical gastrectomy for gastric cancer from January 1985 to December 1994 were reported. Among them, there were 144 gastric cardia cancer cases, 52 cases of gastric body cancer, 168 cases of gastric antrum cancer, 13 cases of leather-like gastric cancer and multiple primary gastric cancers, and 5 cases of residual gastric cancer. It accounted for 69.8% (382/547) of the same period of gastric cancer surgery. Distal distal gastrectomy was performed in 172 patients, proximal gastrectomy in 135 patients, and total gastrectomy in 75 patients. Combined organ resection in 42 cases. Follow-up was followed up 329 cases, the follow-up rate was 86.1%. The 1-, 3-, and 5-year survival rates were 80.7%, 62.9%, and 50.3%, respectively. Early gastric fundus cancer (I_A) was performed for proximal gastrectomy; unsalted serosa of gastric cardial cancer (stage I_B); 5 and 6 lymph nodes without metastasis were reserved for pyloric total gastrectomy. Gastric surgery can effectively prevent reflux esophagitis prolong the food stay on behalf of the “stomach”, consistent with physiology; gastric antrum cancer distal distal gastrectomy. Leaching plasma membrane layer gastric fundus cancer, leather-like gastric cancer, gastric cancer, gastric multiple cancer, residual gastrectomy radical total gastrectomy.