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为了阐明胃癌侵犯横结肠系膜的手术疗效和预后,作者从1970～1990年 Hiroshima 红十字会等医院手术治疗1624例胃癌病例中,选出50例侵犯横结肠系膜患者进行分析。临床病理表现:扪及腹块19例,侵及胰腺或横结肠等器官26例,广泛淋巴结转移24例,腹膜播散26例,行胃切除27例,扩大淋巴结清扫20例,合并其他脏器切除20例。平均肿瘤大小97mm。27例肿瘤占据胃2/3以上,29例肿瘤呈环状。37例为浸润型癌(Borrmann3型和4型),35例肿瘤分化不良,印戒形或粘液样癌。34例手术为非治愈性。结局:33例死于胃癌,9例死于其他疾病,其中6例与术后并发症有关。在33例因癌肿死亡病人中,有腹膜播散21例、局部扩展12例、胸腔渗液8例和其他8例。分析生存曲线,3年生存率受下列因素的影响:腹膜播散,手术的彻底性,淋巴结清扫,合并其他脏器切除和治愈性,至于病人的年龄、性别、可扪
In order to elucidate the surgical outcomes and prognosis of gastric cancer invasion of the transverse mesocolon, the author selected 50 cases of transverse colonic mesentery patients from 1970 to 1990 Hiroshima Red Cross and other hospitals to treat 1624 cases of gastric cancer for analysis. Clinicopathological findings: 19 cases of hernia and abdominal mass, 26 cases of invasion of pancreas or transverse colon, 24 cases of extensive lymph node metastasis, 26 cases of peritoneal dissemination, 27 cases of gastrectomy, 20 cases of enlarged lymph node dissection, and other organs removed 20 cases. The average tumor size is 97mm. Twenty-seven tumors occupied more than 2/3 of the stomach, and 29 tumors were annular. Thirty-seven cases were infiltrating carcinomas (Borrmann types 3 and 4), and 35 had poorly differentiated tumors, signet ring or mucoid carcinoma. Thirty-four cases were non-curative. Outcomes: 33 cases died of gastric cancer and 9 cases died of other diseases, of which 6 cases were related to postoperative complications. Among the 33 patients who died of cancer, there were 21 cases of peritoneal dissemination, 12 cases of local expansion, 8 cases of pleural effusion and 8 cases. To analyze the survival curve, the 3-year survival rate was affected by the following factors: peritoneal dissemination, thorough surgical procedures, lymph node dissection, combined with other organ resections, and curativeness, as well as the patient’s age, gender, and obstinacy.