Gertsch P, Chow L W, Yuen S T, Chau K Y, Lauder I J
Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Eur J Surg. 1996 Sep;162(9):723-7.
To find out whether massive bleeding or free perforation of advanced gastric carcinoma affect long term survival after gastrectomy.
Retrospective analysis of prospectively collected data.
Teaching hospital, Hong Kong.
Gastrectomy.
Long term survival.
Data of 50 patients with gastric carcinoma that had penetrated the serosa (pT3) and who were operated on between 1985 and 1990 were analysed. A total of 17 patients with tumour free perforation and 10 with massive bleeding underwent emergency gastrectomy, and 23 patients with comparable uncomplicated tumours had elective gastrectomy. Twelve variables that could have influenced survival including malignant perforation, bleeding, or the absence of complications were analysed using the Cox's proportional hazards model. Survival was influenced only by proliferative cell nuclear antigen (PCNA) index and not by perforation, bleeding, or the uncomplicated nature of the tumour.
These findings suggest that perforation or bleeding from advanced gastric carcinomas do not significantly affect long term survival after gastrectomy.
探讨进展期胃癌大出血或游离穿孔是否会影响胃切除术后的长期生存。
对前瞻性收集的数据进行回顾性分析。
香港的教学医院。
胃切除术。
长期生存。
分析了1985年至1990年间接受手术的50例穿透浆膜（pT3）的胃癌患者的数据。共有17例无肿瘤穿孔患者和10例大出血患者接受了急诊胃切除术，23例具有类似非复杂性肿瘤的患者接受了择期胃切除术。使用Cox比例风险模型分析了12个可能影响生存的变量，包括恶性穿孔、出血或无并发症情况。生存仅受增殖细胞核抗原（PCNA）指数影响，而不受穿孔、出血或肿瘤的非复杂性影响。
这些发现表明，进展期胃癌的穿孔或出血不会显著影响胃切除术后的长期生存。
