摘要
目的：探讨残胃癌的内镜特点及临床诊断和治疗。方法：回顾性分析我院1996年8月～2006年12月10年问收治的经内镜检查确诊并行手术或综合治疗的15例残胃癌病人的内镜特点及治疗结局。结果：（1）内镜特点：不规则隆起病变9例，溃疡4例，粘膜糜烂和渗血2例。残胃吻合口癌10例，残胃小弯侧癌2例，残胃贲门部癌3例。Hp感染11例（73．3％），中、低分化腺癌占86．7％。临床病理分期：Ⅱ期20．0％，Ⅲ、Ⅳ期80％。（2）治疗结局：3例综合支持治疗患者存活3～6个月，4例行姑息性切除术患者存活6～18个月。根治性切除8例，其中全胃切除Roux-Y食管空肠吻合5例，全胃合并脾切除Roux-Y食管空肠吻合3例，患者存活1年6个月1例，2年1例，2年6个月2例，3年以上3例，1例存活已超过5年。结论：男性、病程10年以上、毕Ⅱ术式、感染Hp均为残胃癌的高危因素，癌变多发生于吻合口，恶性程度高，定期胃镜复查和合理的根治性手术是提高残胃癌病人生存率的关键。
Objective： To investigate the diagnosis, therapy and endoscopic features of gastric remnant carcinoma （GRC）. Methods. A retrospective study was undergone on 15 GRC patients＇ data including endor scopic features and therapy results who were diagnosed by endoscopy and treated through operation or combined therapy from Aug 1996 to Dec 2006 in our hospital. Results： （1） Endoscopic features： 9 cases of irregular bulged changes, 4 ulcer cases, 2 mucosal erosion and errhysis. Stoma cancerization in 10 cases, remnant lesser gastric curvature carcinoma in 2 cases, remnant cardiac stomach carcinoma in 3 cases; 11 patients were with Hp infection （73. 3%）; 86. 7% were middle, poorly differentiated adenocancinoma; clinical pathological stage： Ⅱ 20.0%, Ⅲ, Ⅳ 80%. （2） Therapy results： 3 patients were undergone supportive treatment instead of surgery and survived 3-6 months, 4 cases were undergone palliative resection with 6 months to 1.5 years of survival. 8 patients were undergone radical resection, 5 cases of Roux-Y esophago-jejunal anastomosis, 3 cases of total gastrectomy with splenectomy Roux-Y esophago-jejunal anastomosis, with 1.5 years of survival in 1 patient, 2 years in 1 patient, 2.5 years in 2 patients, over 3 years in 3 patients, and over 5 years of survival in 1 patients. Conclusions： In our study the risk factors of gastric remnant cancer included gender （male）, longer than 10 years of medical history, Billroth＇s Ⅱ method and Hp infection. Cancerization was usually located at stoma, with poorly differentiated carcinoma. Gastric endoscopy examination and reasonable radical resection are the key to improve the survival rate.
出处
《新疆医科大学学报》
CAS
2007年第10期1120-1122,共3页
Journal of Xinjiang Medical University
关键词
残胃癌
内镜
诊断
治疗
gastric remnant carcinoma
endoscope
diagnosis
therapy
