论文部分内容阅读
目的：探讨胃癌切除术切端癌残留与胃癌病理特点的关系，预防切端癌残留的手段。方法：回顾分析１１４８例胃癌根治术切端癌残留 ８０例。结果：胃癌切除术切端癌残留率为 ６． ９７％。上切端癌残留６５例，下切端癌残留１３例，上下切端均有癌残留２例。远端胃切除术切端癌残留率为３．０９ ％，近端胃切除术和全胃切除术切端残留率为１１．２５％，两者有显著差异（Ｐ＜０．０１）。胃上部癌经胸腹联合手术切端癌残留率为２．２７％，而经腹手术切端癌残留率为１２．０７％，两者有显著差异（Ｐ＜０．０５）。切端癌残留与癌肿的大体类型、肿瘤大小、分化程度、浸润深度及ＴＮＭ分期有关。结论：ＢｏｒｍａｎｎⅢ、Ⅳ型胃癌、癌肿＞５ｃｍ、分化程度差、癌肿侵及浆膜或浆膜外、ＴＮＭ分期Ⅲ、Ⅳ期者易发生切端癌残留，特别是胃上部癌经腹手术者。早期胃癌中Ⅱｂ、Ⅱｃ型与正常胃粘膜分界不清，易致切端癌残留。
Objective: To investigate the relationship between residual gastric cancer resection and pathological features of gastric cancer and to prevent the residual cancer. Methods: A retrospective analysis of 1148 cases of radical resection of gastric cancer residual 80 cases. Results: The residual rate of endoscopic resection of gastric cancer was 6. 97%. There were 65 cases with end-cancer and 13 cases with end-cancer. There were 2 cases of cancer residual in the upper and lower incision. The residual rate of distal gastrectomy was 3.09%. The residual rate of proximal gastrectomy and total gastrectomy was 11.25%. There was a significant difference (P <0.01). There was a significant difference (P <0.05) between the two groups in the residual rate of end-stage carcinoma after thoracoabdominal surgery in 2.27%. Tail resection of cancer and the general type of cancer, tumor size, degree of differentiation, depth of invasion and TNM staging. Conclusion: Bormann Ⅲ, Ⅳ type of gastric cancer, cancer> 5cm, poorly differentiated, cancer invasion and serosal or serosal, TNM stage Ⅲ, Ⅳ are prone to end-cancer, especially gastric upper abdominal cancer patients . Early gastric cancer Ⅱ b, Ⅱ c type and normal gastric mucosa unclear boundaries, easy to cause cut-end residual cancer.