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目的:探讨Ⅳ期胃癌合理的手术方式。方法:1978 年～1992 年间对772 例Ⅳ期胃癌进行了手术治疗,将Ⅳ期胃癌根据其不同的TNM 构成分为Ⅳa 、Ⅳb 、Ⅳc 三个亚期, 并分别采用不同的手术方式, 观察术后的5 年生存率。结果:Ⅳa 期病例施行根治切除组术后的5 年生存率为15 .4 % ,高于一般根治手术组的6.9 % 。结论:对Ⅳ期胃癌应根据亚期的不同采用不同的术式, 仅由T4b 或N3 一项构成的Ⅳa 期病例应选择行根治性手术或联合脏器切除术,Ⅳb 期可行姑息切除,同时行所属淋巴结清除,必要时行其他转移灶切除。Ⅳc 应根据病情行简单手术。
Objective: To explore the reasonable surgical methods for stage IV gastric cancer. Methods: 772 cases of stage IV gastric cancer were treated surgically between 1978 and 1992. Stage IV gastric cancer was divided into three sub-stages IVa, IVb, and IVc according to their different TNM components. Different surgical methods were used. After the 5-year survival rate. RESULTS: The 5-year survival rate in the radical resection group was 15.4% in IVa cases, which was 6.9% higher than that in the general radical surgery group. Conclusion: For stage IV gastric cancer, different procedures should be used according to different substages. Only IVa patients with T4b or N3 should be selected for radical surgery or combined organ resection. IVb should be feasible for palliative resection. The lymph nodes were removed and other metastases were removed as necessary. IVc should be based on simple surgery.