Saubier E C, Partensky C, Gouillat C, Berger F, Moulinier B
J Chir (Paris). 1982 Jan;119(1):13-20.
Gastrectomy was performed in 30 patients with superficial gastric cancer, equivalent to 12 p. cent of cases operated upon for gastric neoplasms since 1970. Presenting signs were epigastralgia in 19 cases (in 12 cases of the ulcer type), external bleeding from the digestive tract in 4 cases, dyspeptic disorders in 2 cases, and anaemia in one patient. The lesion was asymptomatic in 4 cases, while in 3 patients it was detected by endoscopy after polypectomy or for achlorhydria. In one case the lesion was discovered completely fortuitously. Cancer was suspected by the endoscopist from gross pathological findings in 7 of the 30 cases. An adenocarcinoma was diagnosed after biopsy in 26 cases, and suspected in the remaining 4 patients. Sub-total gastrectomy was employed in 27 cases, total gastrectomy in 2 cases, and extension to a total gastrectomy in one patient. Gross pathology showed cancer of type I : 8 cases, type II (IIa : 1, IIb : 0, IIc : 10) : 11 cases, type III : 6 cases, and mixed types IIc + III : 5 cases. The submucosa was invaded 17 times, the other 13 lesions involving the mucosa only. There were no immediate postoperative deaths. Three patients were not seen again, while 7 died from secondary causes : 5 for reasons unrelated to their cancer and 2 from unknown causes. By applying strict attention to surgical procedures and precise examination of histological data it should be possible to obtain postoperative survivals comparable to those of Japanese series (80 to 90 p. cent at 5 years, 70 p. cent at 10 years).
对30例浅表性胃癌患者实施了胃切除术，相当于自1970年以来因胃部肿瘤接受手术治疗病例的12%。主要症状为上腹部疼痛19例（其中溃疡型12例），消化道外出血4例，消化不良2例，贫血1例。4例病变无症状，3例患者在息肉切除术后或因胃酸缺乏经内镜检查发现病变。1例病变完全偶然发现。30例中有7例内镜医师根据大体病理表现怀疑为癌症。26例经活检诊断为腺癌，其余4例怀疑为腺癌。27例行次全胃切除术，2例行全胃切除术，1例由次全胃切除术扩大为全胃切除术。大体病理显示：Ⅰ型癌8例，Ⅱ型（Ⅱa：1例，Ⅱb：0例，Ⅱc：10例）11例，Ⅲ型6例，Ⅱc+Ⅲ混合型5例。黏膜下层受侵17次，其他13例病变仅累及黏膜。术后无即刻死亡病例。3例患者失访，7例死于继发原因：5例与癌症无关，2例死因不明。通过严格注意手术操作并精确检查组织学数据，应有可能获得与日本系列相当的术后生存率（5年生存率80%至90%，10年生存率70%）。
