摘要
目的 探讨胃癌穿孔患者的临床病理特征及外科手术治疗方式的选择。方法 回顾性分析 48例胃癌穿孔患者的临床病理、手术方式及生存期资料。结果 患者平均年龄 5 8岁。病理分期I期 3例 ,II期 11例 ,III期 2 1例 ,IV期 13例。 2 9例作急诊胃切除术 ,手术死亡率 6.9% ;6例先作穿孔修补术 ,术后 3周作胃切除术 ,无手术死亡 ;13例作穿孔修补或加作胃空肠吻合术 ,手术死亡率2 3 .1%。胃切除术者术后中位生存期 2 8个月 ( 13～ 72个月 ) ,胃穿孔修补术者中位生存期 7个月( 3～ 10个月 )。结论 急诊胃切除术是治疗胃癌急性穿孔的合理方法 ,如情况不允许 ,可行分期手术以降低手术死亡率。
Objective To investigate the clinical and pathological characteristics as well as the surgical treatment of perforated gastric carcinoma (PGC). Methods The clinical and pathological data, surgical treatment and survival time of 48 patients with PGC were retrospectively analyzed. Results The mean age was 58 years in the 48 patients with PGC. There were 3 tumors in stage I, 11 in stage II, 21 in stage III , and 13 in stage IV. Emergency gastrectomy was done in 29 patients, with the mortality was 6.9%. Six patients underwent local repair at first, gastrectomy was done 3 weeks later without postoperative death. Perforation repair with or without gastroenterostomy was performed in 13 patients, with the mortality was 23.1% .The median survival time in gastrectomy group was 28 months (ranged 13 to 72 months) and in repair group was 7 months (ranged 3 to 10 months). Conclusions Emergency gastrectomy is the choice of treatment for PGC. If the conditions is not suitable for emergent gastrectomy ,staging operation should be adoptted to reduce operative mortality.
出处
《中国普通外科杂志》
CAS
CSCD
2003年第7期517-519,共3页
China Journal of General Surgery
