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目的 研究残胃贲门癌发病规律及探讨外科术式。方法 回顾分析我院 1986年至 2 0 0 1年残胃贲门癌病人的病例资料。结果 残胃贲门癌 2 1例 ,18例因胃十二指肠溃疡而行胃大部切除术 ,其中BillrothⅡ式术后 16例 ,BillrothⅠ式 2例。本组 2 1例残胃贲门癌中 ,16例行残胃全切 ,食管空肠Roux -y吻合术。 2例行残胃贲门部切除 ,食管余胃吻合术。拒绝手术 1例。 1例术中见腹腔广泛转移行活检术。 1例行空肠造瘘术。全组无近期死亡 ,18例残胃贲门癌切除病人术后进食情况及生存质量均良好。结论 胃大部切除患者应终身定期随访 ,以期较早发现残胃贲门癌。绝大多数残胃贲门癌需行残胃及吻合口全部切除 ,食管空肠Roux -y吻合术。
Objective To study the incidence of gastric cardia gastric cancer and explore the surgical technique. Methods A retrospective analysis of our hospital from 1986 to 2001 cases of gastric cardia patients with gastric cancer. Results Residual gastric cardia cancer in 21 cases, 18 cases of gastric ulcer due to partial gastrectomy, including Billroth Ⅱ after 16 cases, Billroth Ⅰ 2 cases. The group of 21 cases of gastric cardia cancer, 16 cases of gastric stump resection, Roux -y esophageal anastomosis. 2 cases of gastric cardia resection, esophageal gastric anastomosis. Refuse surgery in 1 case. In 1 case, intraperitoneal extensive metastasis biopsy was seen. A routine jejunostomy. The whole group without recent deaths, 18 cases of gastric resection of gastric cardia patients after eating and quality of life were good. Conclusion Most patients with subtotal gastrectomy should be regularly followed for a long time, with a view to early detection of gastric cardia. The vast majority of gastric cardia cancer need gastric and anastomotic resection, Roux -y esophageal anastomosis.