Takeda J, Toyonaga A, Koufuji K, Kodama I, Aoyagi K, Yano S, Ohta J, Mizutani K, Shirouzu K
Department of Gastroenterology and Surgery, Kurume University School of Medicine, Japan.
Kurume Med J. 1996;43(4):267-72. doi: 10.2739/kurumemedj.43.267.
Forty-five cases of remnant-stump (R-S) gastric cancer were investigated retrospectively, comparing those which were initially benign (Group 1: 31 cases) with those which were initially malignant (Group 2: 14 cases). The incidence of R-S gastric cancer over all gastrectomy cases from 1967 to 1994 was 1.4% (45/3,282). The mean period until development of the R-S gastric cancer following partial gastrectomy was 21.6 years in Group 1 and was 15.8 years in Group 2 (p < 0.05). Of those R-S cases that underwent resection, total gastrectomy was selected for 82% in Group 1 and for 85% in Group 2. The incidence of negative lymph nodes was only 25% in Group 1 and 62% in Group 2 (p < 0.05). The pathological stage I was 21% in Group 1 and 54% in Group 2 (p < 0.05). The 5-year-survival rate was 32% in Group 1 and was 62% in Group 2 (p < 0.05). To improve the prognosis for R-S gastric cancer, periodic endoscopic follow-up examinations to find any R-S cancer at the earliest stage is most important, especially in cases of a partial gastrectomy for an initially benign case.
对45例残端（R-S）胃癌患者进行回顾性研究，将最初为良性的患者（第1组：31例）与最初为恶性的患者（第2组：14例）进行比较。1967年至1994年期间，所有胃癌切除病例中R-S胃癌的发生率为1.4%（45/3282）。第1组部分胃切除术后发生R-S胃癌的平均时间为21.6年，第2组为15.8年（p<0.05）。在接受切除的R-S病例中，第1组82%选择了全胃切除术，第2组为85%。第1组淋巴结阴性的发生率仅为25%，第2组为62%（p<0.05）。第1组病理I期为21%，第2组为54%（p<0.05）。第1组的5年生存率为32%，第2组为62%（p<0.05）。为改善R-S胃癌的预后，定期进行内镜随访检查以尽早发现任何R-S癌最为重要，尤其是对于最初为良性病例的部分胃切除术患者。
