Furukawa H, Hiratsuka M, Iwanaga T
Department of Surgery, Centre for Adult Diseases, Osaka, Japan.
Br J Surg. 1988 Feb;75(2):116-9. doi: 10.1002/bjs.1800750209.
Borrmann type 4 gastric carcinoma, including linitis plastica, is difficult to detect at an early stage and the results of surgical treatment remain poor. We have used 'left upper abdominal evisceration plus Appleby's method (LUAE + Apl.)' as a radical surgical procedure for this disease. During the period 1983-86, 30 cases of Borrmann type 4 gastric carcinoma underwent this procedure (Group A). These cases were compared with 30 patients who underwent total gastrectomy with pancreaticosplenectomy (Group B) during the period 1980-82. Although this is not a randomized study and the extent of resection was greater in Group A, the operation time, amount of blood loss, and number of complications were similar for both methods. When the survival rates were compared, the 3-year survival rate in stage II-III cases was higher for Group A (83.3 per cent) than for Group B (42.2 per cent) (P less than 0.05). One patient in Group A and 12 patients in Group B died with peritoneal metastasis within 3 years of operation in stage II-III. The LUAE + Apl. method is a rational and useful technique for the surgical treatment of Borrmann type 4 gastric carcinoma.
包括皮革胃在内的Borrmann 4型胃癌很难早期发现，手术治疗效果仍然不佳。我们采用“左上腹脏器清除术加Appleby法（LUAE + Apl.）”作为这种疾病的根治性手术方法。在1983 - 1986年期间，30例Borrmann 4型胃癌患者接受了该手术（A组）。将这些病例与1980 - 1982年期间接受全胃切除术加胰脾切除术的30例患者（B组）进行比较。尽管这不是一项随机研究，且A组的切除范围更大，但两种方法的手术时间、失血量和并发症数量相似。比较生存率时，A组II - III期病例的3年生存率（83.3%）高于B组（42.2%）（P小于0.05）。II - III期患者中，A组有1例患者和B组有12例患者在术后3年内死于腹膜转移。LUAE + Apl.法是治疗Borrmann 4型胃癌的一种合理且有用的技术。
