Fujiwara T, Hirose S, Hamazaki K, Iwagaki H, Mano K, Orita K
First Department of Surgery, Okayama University Medical School, Japan.
Hepatogastroenterology. 1996 Mar-Apr;43(8):416-9.
BACKGROUND/AIMS: The clinicopathological features of 34 cases of gastric cancer in the remnant stomach were examined.
Twenty-three patients who underwent primary gastrectomy for benign gastric disease (Group I) and 11 patients who received gastrectomy because of primary gastric cancer (Group II) were studied.
The median age at diagnosis of gastric remnant cancer was 62.2 years in Group I and 63.7 years in Group II. The median time interval between the primary operation and the appearance of gastric cancer was 12.6 years in Group I and 6.5 years in Group II. Almost all patients were symptomatic; presenting epigastralgia and constriction. The first diagnostic procedure for these patients was barium examination of the remnant stomach except one patient diagnosed by emergency gastroscopy for hematemesis. Seventy percent of patients in Group I had advanced gastric cancer, most of which were invasive to seromuscular layers, whereas in Group II early gastric cancer was dominant (55%). The prognostic evaluation after the second surgery showed that patients with early stages of cancer had longer survival in both Groups.
These results suggest that early detection of gastric cancer in the remnant stomach by periodical follow up is important and that the application of aggressive surgery for this disease will provide better patient survival.
背景/目的：对34例残胃癌的临床病理特征进行研究。
研究23例因良性胃部疾病接受初次胃切除术的患者（第一组）和11例因原发性胃癌接受胃切除术的患者（第二组）。
第一组残胃癌诊断时的中位年龄为62.2岁，第二组为63.7岁。第一组初次手术与胃癌出现之间的中位时间间隔为12.6年，第二组为6.5年。几乎所有患者均有症状，表现为上腹部疼痛和梗阻。这些患者的首次诊断方法除1例因呕血行急诊胃镜检查确诊外，其余均为残胃钡餐检查。第一组70%的患者为进展期胃癌，多数侵犯浆肌层，而第二组早期胃癌占主导（55%）。二次手术后的预后评估显示，两组中癌症早期患者的生存期更长。
这些结果表明，通过定期随访早期发现残胃癌很重要，并且对该疾病采用积极的手术治疗将为患者提供更好的生存预后。
