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胃切除术后残胃发生癌症

[Occurrence of cancer in the gastric stump after stomach resection].

作者信息

Popov P, Brailski Kh

出版信息

Vutr Boles. 1979;18(1):33-8.

PMID:433249
Abstract

The investigation of 654 patients with gastric resection on the occasion of benign gastric diseases (17 with duodenal and 6 with gastric ulcers and 2 with polyps of the stomach) revealed cancer origination in the remaining part of the stomach in 25 patients (3.82%). The average of the patients at resection was 41 and the cancer confirmation in the stomach remaining part--63 (cancer process develops after about an average of 22 years--from 8 to 38 years after the resection)--in 16 of the patients in the region of the anastomosis and in the rest--at a distance from it. Cancer in the stomach remaining part was admitted in 28 per cent on the base of clinical-laboratory data, roentgenologically was diagnosed and admitted in 64 per cent and fibrogastroscopically in 52 per cent. In 80 per cent of the patients positive cancer results were obtained by purposeful gastrobiopsy. Severe atrophic gastritis in the adjoining mucosa was found in 88 per cent of the examined. Radical operation treatment (total and subtotal gastric resection) was performed to 44 per cent of the patients, the rest were inoperable. The resected stomach is a precancerosis dur to which the patients should be enlisted in the dispensary system (particularly after the 10th year after the resection) and every year to be clinically, laboratory and endoscopically-biopsy controlled with a view to the timely diagnosis of the cancer of the stomach remaining part.

摘要

对654例因良性胃部疾病(十二指肠溃疡17例、胃溃疡6例、胃息肉2例)接受胃切除术的患者进行调查发现,25例(3.82%)患者的残胃发生了癌变。切除时患者的平均年龄为41岁,残胃癌确诊时平均年龄为63岁(癌变过程平均在切除后约22年发生,从8年至38年不等),其中16例发生在吻合口区,其余发生在离吻合口有一定距离处。根据临床实验室数据,28%的患者残胃被确诊为癌,经X线诊断确诊的占64%,经纤维胃镜诊断确诊的占52%。80%的患者通过有目的的胃活检获得了阳性癌症结果。88%的受检患者在毗邻黏膜处发现了重度萎缩性胃炎。44%的患者接受了根治性手术治疗(全胃和次全胃切除术),其余患者无法手术。切除的胃是一种癌前病变,因此患者应被纳入门诊系统(特别是在切除术后第10年之后),并且每年应进行临床、实验室和内镜活检检查,以便及时诊断残胃癌。

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