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目的探讨残胃癌有效的外科治疗方式。方法良性疾病行远端胃大部分切除后发生残胃癌21例(良性组),恶性疾病远端胃大部分切除后发生残胃癌17例(恶性组),研究两组临床病理特征和外科治疗方式。结果良性组吻合口处肿瘤及空肠系膜淋巴结转移高于恶性组,在恶性组Ⅳ期患者及左上腹脏器切除高于良性组,良性组、治愈性切除及早期残胃癌患者1、3、5年生存率分别高于恶性组、非治愈性切除及进展期残胃癌患者。结论应根据良性组和恶性组以前的外科治疗方法行合理的淋巴结切除。在良性组早期残胃癌患者可以行残胃的大部分切除。进展期残胃癌应该行联合周围脏器的全胃切除,甚至行左上腹脏器切除。
Objective To investigate the effective surgical treatment of residual gastric cancer. Methods Twenty-one patients with benign gastric disease (benign group) developed gastric cancer after radical resection of the distal gland. 17 cases of gastric residual gastric cancer (malignant group) occurred after the resection of the distal part of the malignant disease. The clinical and pathological features and surgical treatment . Results The tumors in the anastomotic group and the mesenteric lymph node metastasis in the jejunum were higher than those in the malignant group. In the malignant group, the patients in the stage Ⅳ and the left upper abdomen were higher than those in the benign group, benign group, curative resection and early residual gastric cancer Annual survival rates were higher than in the malignant group, non-healing resection and advanced gastric cancer patients. Conclusions Reasonable lymph node dissection should be performed according to the previous surgical treatment of benign and malignant groups. In the early stage of benign gastric residual gastric cancer patients can be the majority of gastric resection. Progressive residual gastric cancer should be combined with the surrounding organs of the total gastrectomy, and even the left upper quadrant excision.