Perez D, Narayanan N C, Russell J C, Becker D R
Am Surg. 1984 Oct;50(10):538-40.
Gastric carcinoma following surgery for benign peptic ulcer disease is being increasingly reported. The authors have reviewed their experience at Saint Francis Hospital and Medical Center and Mount Sinai Hospital from 1970 to 1980 and found 319 cases of gastric carcinoma, 16 of whom had undergone previous surgical procedures for peptic ulcer disease, with an incidence of 5 per cent of gastric stump carcinoma. The average time interval for the development of gastric stump carcinoma was 17.4 years, ranging from 5 to 49 years. The average survival after the diagnosis was 4.6 months, making the prognosis uniformly poor, probably due to delayed diagnosis. Treatment modalities consisted of major and minor surgical procedures, medical therapy, and no treatment in some instances. It is recommended that all patients who undergo operations for peptic ulcers have careful long-term follow-up. Vague gastrointestinal symptoms occurring in these patients, especially 10 years or more after surgery, require endoscopy and biopsies of the gastric stump to exclude gastric stump carcinoma.
良性消化性溃疡病手术后发生胃癌的报道越来越多。作者回顾了他们在圣弗朗西斯医院和医疗中心以及西奈山医院1970年至1980年期间的经验，发现319例胃癌患者中，有16例曾因消化性溃疡病接受过手术，胃残端癌的发生率为5%。胃残端癌发生的平均时间间隔为17.4年，范围从5年至49年。诊断后的平均生存期为4.6个月，预后普遍较差，可能是由于诊断延迟所致。治疗方式包括大手术和小手术、药物治疗，在某些情况下不进行治疗。建议所有接受消化性溃疡手术的患者都要进行仔细的长期随访。这些患者出现的模糊胃肠道症状，尤其是手术后10年或更长时间出现的症状，需要进行内镜检查和胃残端活检以排除胃残端癌。
