Zwaveling A
Arch Chir Neerl. 1976;28(1):5-12.
During the period 1958 to 1972 inclusive, 217 patients were subjected to a palliative operation because of carcinoma of the stomach. Subtotal gastric resection was performed in 33 and a total resection in 42 cases. The postoperative mortality in the resected group amounted to 8%. The average duration of survival with exclusion of the postoperative mortality amounted to 17 months with a median duration of 12 months. Five patients in this group (7%) survived for 5 years, and two patients are still alive without recurrence 9 and 6 years, respectively, after the operation. Among the 142 remaining patients, the postoperative mortality was 23%. The average survival with exclusion of the postoperative mortality was 5 months; the median duration of survival amounted to 4 months. The average duration of survival among the patients subjected to a gastro- or jejunostomy was shorter: 3 months, with a median of 2 months. Of the various palliative measures, resection is to be preferred. If it is not feasible, gastro-enterostomy and intubation may be considered. In a limited number of cases, the alimentary fistula may still be indicated, even though it is an unsatisfactory type of palliation. Hoerr's classification is satisfactory as a clinical subdivision. The dividing line between operations with curative and with palliative intent as a rule is put at B III. Of the patients treated palliatively, 92% had died after 2 years; 79% of those subjected to resection and 100% of those subjected to some other intervention.
在1958年至1972年（含）期间，217例胃癌患者接受了姑息性手术。33例行胃次全切除术，42例行全胃切除术。切除组的术后死亡率为8%。排除术后死亡因素后的平均生存期为17个月，中位生存期为12个月。该组中有5例（7%）存活了5年，2例分别在术后9年和6年仍存活且无复发。其余142例患者的术后死亡率为23%。排除术后死亡因素后的平均生存期为5个月；中位生存期为4个月。接受胃造口术或空肠造口术患者的平均生存期更短：3个月，中位生存期为2个月。在各种姑息性措施中，切除术更可取。如果不可行，可以考虑胃肠造口术和插管术。在少数情况下，即使是一种不太理想的姑息方式，仍可考虑行消化道造瘘术。作为一种临床细分，霍尔分类法是令人满意的。通常将具有根治意图和姑息意图的手术分界线定在B III期。接受姑息治疗的患者中，92%在2年后死亡；接受切除术的患者中有79%，接受其他干预措施的患者中有100%。
