Zhang Yubao, Tokunaga Akira, Masuda Gotaro, Okuda Takeshi, Kiyama Teruo, Yoshiyuki Toshiro, Kato Shunji, Matsukura Norio, Tajiri Takashi, Onda Masahiko
Department of Surgery, Nippon Medical School, Japan.
J Nippon Med Sch. 2002 Oct;69(5):489-93. doi: 10.1272/jnms.69.489.
The aim of this study was to evaluate the characteristics, and treatment of gastric remnant cancer based on an analysis of the surgical results of Nippon Medical School over the past 18 years. Thirty seven patients (27 males and 10 females, mean age 60 years) underwent surgery for gastric remnant cancer. Patients who had undergone gastrectomy with Billroth II anastomosis for benign disorder underwent re-gastrectomy for the cancer of gastric remnant 20 years after the first gastrectomy. While, patients who had undergone gastrectomy with Billroth I anastomosis for malignant disorder underwent re-gastrectomy within 10 years after the first gastrectomy. Early-type gastric remnant cancers were not observed in the suture line or gastric stump region, while advanced-type cancers were observed in the anastomotic region. Surgical treatment was carried out by the method of total gastrectomy with Roux-en-Y esophago-jejunal anastomosis. The 5 year survival rates were 77%for early cancer and 14%for advanced cancer. Periodic follow-up endoscopies in gastrectomized patients may be useful for the early detection of gastric remnant cancer after operations for gastric cancer.
本研究旨在通过分析日本医科大学过去18年的手术结果,评估残胃癌的特征及治疗方法。37例患者(27例男性,10例女性,平均年龄60岁)接受了残胃癌手术。因良性疾病行毕Ⅱ式胃切除的患者在首次胃切除术后20年因残胃癌接受再次胃切除。而因恶性疾病行毕Ⅰ式胃切除的患者在首次胃切除术后10年内接受再次胃切除。在吻合口或胃残端区域未观察到早期残胃癌,而在吻合区域观察到进展期癌。手术治疗采用全胃切除加Roux-en-Y食管空肠吻合术。早期癌的5年生存率为77%,进展期癌为14%。胃癌切除术后患者定期进行内镜随访检查可能有助于早期发现残胃癌。