de Castro Parga G, López Saco A, Carracedo Iglesias R, Higuero Grosso A, Cáceres Alvarado N, Urgal González M, Gil Gil P
Servicio de Cirugía General y Aparato Digestivo, Complejo Hospitalario Xeral-Cíes, Pontevedra.
Rev Clin Esp. 1999 May;199(5):264-9.
The incidence of gastric remnant carcinoma ranges between 1% and 9%. We report here our experience in a sanitary area in which, on account of different social and working reasons, the surgical indication for treatment of peptic disease was very common in previous decades.
An analysis was made of the 52 cases of patients operated over the last 12 years, which represents 7.13% of 729 gastric cancers operated over the same time period.
In 67% of cases the carcinoma sat on a type-II stump, in 25% on a B-I type stump, and in the remaining 8% on stomachs with vagotomy and pyloroplasty. Seventy-five percent of patients had two characteristics: to be older than 60 years and to have undergone primary surgery at least 15 years before. Over half of patients were admitted on an emergency basis with no diagnosis and had received prolonged symptomatic therapies without previous examinations. The carcinoma involved the anastomotic mouth in 56% of cases and the histologic intestinal type predominated. Twenty-seven percent of patients had stages I and II, whereas almost half of patients had stage IV. Surgical resection was feasible in 42 cases (81%), with a surgical mortality rate of 21% for resections. The overall survival rate estimated at 5 years was 23%.
The possibility of performing surgery with a curative aim is the main prognostic factor for the gastric remnant carcinoma. The endoscopic study of patients at risk allows for diagnosis in earlier stages and therefore and improvement in results.
残胃癌的发病率在1%至9%之间。我们在此报告我们在一个卫生区域的经验，由于不同的社会和工作原因，在过去几十年中，消化性疾病的手术治疗指征非常普遍。
对过去12年中接受手术的52例患者进行了分析，这占同期729例胃癌手术患者的7.13%。
67%的病例癌位于II型残端，25%位于B-I型残端，其余8%位于行迷走神经切断术和幽门成形术的胃。75%的患者有两个特征：年龄超过60岁且至少在15年前接受过初次手术。超过一半的患者在未确诊的情况下急诊入院，并且在未进行先前检查的情况下接受了长期的对症治疗。56%的病例癌累及吻合口，组织学类型以肠型为主。27%的患者处于I期和II期，而几乎一半的患者处于IV期。42例（81%）患者可行手术切除，切除手术的死亡率为21%。估计5年总生存率为23%。
以治愈为目的进行手术的可能性是残胃癌的主要预后因素。对高危患者进行内镜检查可在早期进行诊断，从而改善治疗结果。
