Kienzle H F
Med Klin. 1977 Mar 11;72(10):399-405.
From 1960 to 1975 29 patients were treated at our clinic for carcinoma of the gastric stump following resection for benign causes. These cases are casuistically put together and their history, clinic, method of operation, and course after operation are described. 2.38p.c. of all carcinomas of the stomach were carcinomas of the stump. The patients were averagely 38.9 years old at the time of resection for benign causes; they were averagely 60.6 years old at the time of diagnosis of the carcinoma. The so called free interval was therefore 22.2 years. The younger a patient is at the time of primary resection, the longer the free interval will be. The history of complaints lasted 3.4 months; main complaints were pains in the epigastrium, loss of weight, vomiting, and aversion for meat. The carcinomas were located in 60p.c. at the anastomosis, in 36p.c. at the cardia of the stomach. Other locations were distributed over the whole gastric stump. 14 patients could be subjected to gastrectomy with interposition of jejunum, while the rest of the cases were primarily inoperable or were treated with prothesis. All types of carcinomas of the stomach were found in the stump, in 56p.c. the adeno-carcinoma prevailed. 32p.c. of the patients died in the clinic; 17 patients could leave the clinic more or less complaintless. These patients were on the average 24.8 days in the clinic and survived at home averagely 8.5 months. In the introduction, the discussion and on a table the informations of other workers are discussed and their results compared with our findings. We come impressively to the conclusion, that a resection for ulcer is no predisposing factor in the development of a carcinoma of the gastric stump. This causal connection may be established, when wide range statistics are available, which are compiled under controlled and comparable conditions.
1960年至1975年间，我院对29例因良性病因行胃切除术后发生残胃癌的患者进行了治疗。现将这些病例汇总，并描述其病史、临床表现、手术方法及术后病程。胃残端癌占所有胃癌的2.38%。患者因良性病因行胃切除时平均年龄为38.9岁；诊断为残胃癌时平均年龄为60.6岁。因此，所谓的无癌间期为22.2年。患者首次切除时年龄越小，无癌间期越长。主诉病史持续3.4个月；主要症状为上腹部疼痛、体重减轻、呕吐及厌肉。60%的癌位于吻合口处，36%位于胃贲门部。其他部位分布于整个胃残端。14例患者可行胃切除加空肠间置术，其余病例起初无法手术或采用假体治疗。胃残端发现了所有类型的胃癌，其中56%为腺癌。32%的患者在我院死亡；17例患者出院时或多或少无不适症状。这些患者在我院平均住院24.8天，在家平均存活8.5个月。在引言部分，讨论了其他研究者的资料，并将他们的结果与我们的发现进行了比较。我们令人印象深刻地得出结论，溃疡切除术不是胃残端癌发生的 predisposing因素。当有在可控且可比条件下收集的广泛统计数据时，这种因果关系可能得以确立。 （注：原文中“predisposing”可能有误，推测可能是“predisposing”，意为“诱发的、易导致的” ，这里按推测翻译为“诱发因素” ，具体需结合原文准确词汇含义进一步确定 ）
