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作者对54例胃癌切除标本断端癌细胞残留(断端阳性)情况进行分析。认为降低术后断端阳性率的因素有胃贲门癌的近侧根治性切除或全胃切除时,食管切缘距肿瘤的距离至少在3～6cm;在胃癌手术中,单纯经腹或经胸切口都会使胃癌近侧切除或全胃切除的范围受影响,而胸腹联合切口者,其断端阳性率远较前者为低。作者认为,提高胃癌外科手术的治疗效果应改变传统观念的影响,将十二指肠切除的范围给予充分考虑,还需加强对胃癌生物学行为的研究,使胃癌切除术更加规范。
The authors analyzed the residual (positive side) cancer cells in 54 cases of gastric cancer resection specimens. It is believed that the lowering of the positive rate of postoperative segmental disconnection is the proximal radical resection or total gastrectomy for gastric cardia cancer. The distance between the esophageal margin and the tumor is at least 3 to 6 cm; in gastric cancer, transabdominal or transthoracic surgery is simple. Incisions will affect the extent of proximal resection or total gastrectomy of gastric cancer. However, in the combined thoracoabdominal incision, the positive rate of broken end is much lower than the former. The author believes that improving the therapeutic effect of gastric cancer surgery should change the impact of the traditional concept, give full consideration to the scope of duodenal resection, but also need to strengthen the study of biological behavior of gastric cancer, so that the resection of gastric cancer is more standardized.