已侵犯周围脏器胃癌的手术范围评价

• 作 者: 陈国林 王凤君 庞达 曲宏岩 杨富强
• 机 构: 哈尔滨医科大学附属第三医院腹外科!黑龙江哈尔滨150040,哈尔滨医科大学附属第三医院腹外科!黑龙江哈尔滨150040,哈尔滨医科大学附属第三医院腹外科!黑龙江哈尔滨150040,哈尔滨医科大学附属第
• 出 处: 哈尔滨医科大学学报
• 发表日期: 1999年05期
• 关键词: 胃肿瘤 腹腔种植转移 术后生存率 联合脏器切除 腹膜种植转移 姑息性切除术 近端胃切除 低分化腺癌 肝左叶 胃周淋巴结

探讨已侵犯周围脏器Ⅳ期胃癌患者的手术方式及术后生存率。１４６ 例患者行根治性手术占７８－８％ ，行姑息手术占２１－２％ 。该组患者总的术后１、３ 和５ 年的生存率分别为７０－６％ 、３８－８％ 和２３－９％ 。根治组和姑息组因不具备可比性，故未进行生存率对比。结果表明，当胃癌已经侵犯了邻近脏器时，如果不存在不可治愈因素（ 如腹腔种植转移、血循转移等），应力求行根治性手术。否则应力求行简单的以切除原发病灶为主的姑息性手术，为术后综合治疗打下基础。

To investigate the surgical methods and postoperative survival rates of patients with stage IV gastric cancer that have violated surrounding organs. Radical surgery accounted for 78-8% of 146 patients and palliative surgery accounted for 21-2%. The overall 1-, 3-, and 5-year survival rates for this group of patients were 70-6%, 38-8%, and 23-9%, respectively. Since the radical and palliative groups were not comparable, no survival rate was compared. The results showed that when gastric cancer has invaded neighboring organs, if there are no incurable factors (such as abdominal plantation metastasis, blood circulation, etc.), radical surgery should be pursued. Otherwise, the stress should be reduced to a simple palliative operation with the primary lesion removed. This will lay the foundation for postoperative comprehensive treatment.