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目的 探讨无法根治性切除的晚期胃癌的外科治疗方法。方法 对 135例无法根治性切除的晚期胃癌所实施的 4种姑息手术方式进行回顾性分析。结果 姑息性全胃切除术 2 5例 ,次全胃切除术 5 9例 ,胃空肠吻合术 40例 ,营养性空肠造瘘 11例。姑息性全胃切除术、次全胃切除术、胃空肠吻合术及营养性空肠造瘘术的 1a和 2a生存率分别为 5 6 %,2 8%;47.5 %,2 2 %;10 %,0 ;0 ,0。其症状缓解率分别为 76 %,88.1%,6 5 %,18.1%。其手术死亡率和吻合口漏发生率分别为 4%,4%;5 .1%,3.4%;2 .5 %,0 ;0 ,0。结论 对于无法根治性切除的胃癌病人 ,选择性地采取积极的姑息性切除治疗 ,可延长患者的生存时间。
Objective To investigate the surgical treatment of advanced gastric cancer without radical resection. Methods A retrospective analysis of four palliative procedures performed in 135 patients with unresectable advanced gastric cancer was performed. Results Palliative gastrectomy in 25 cases, subtotal gastrectomy in 59 cases, gastrojejunostomy in 40 cases, 11 cases of nutritional jejunostomy. The 1a and 2a survival rates of palliative gastrectomy, subtotal gastrectomy, gastrojejunostomy and nutritional jejunostomy were 56%, 28%, 47.5%, 22%, 10% 0; 0, 0. The symptom relief rates were 76%, 88.1%, 65%, 18.1% respectively. The operative mortality and anastomotic leakage rates were 4%, 4%, 5.1%, 3.4%, 2.5%, 0%, 0%, respectively. Conclusion For patients with unresectable gastric cancer, selective active palliative resection can prolong the survival time of patients.