中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (10): 814-815.

• 专题笔谈 • 上一篇    下一篇

残胃癌外科治疗原则

季加孚   

  1. 北京大学临床肿瘤学院 北京肿瘤医院暨北京市肿瘤防治研究所外科，北京100142
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-10-01 发布日期:2009-10-01

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-10-01 Published:2009-10-01

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摘要：

残胃癌在临床上属少见病，但其发病率并未下降、今后仍会不时遇到此类病人。鉴于残胃癌早期诊断率低，预后不佳，了解其治疗原则是很重要的。残胃癌的外科治疗须行残全胃切除加上至少D2 范围的淋巴结清扫。而残胃癌的淋巴转移模式与原发胃癌不同，例如报道中常见空肠系膜和下纵隔处淋巴结转移。因此残胃癌需要清扫包括一些在原发胃癌手术时不作为常规清扫的站别。在进行了根治性的治疗后，残胃癌的预后与原发近端胃癌并无区别。

关键词: 残胃癌；消化道重建, 淋巴结清扫

Abstract:

Principles of surgical treatment of gastric stump carcinoma JI Jia-fu. Department of Surgical, Peking Vniersity School of Oncology, Beijing Institute for Cancer Research, Beijing 100142, China Abstract Gastric stump carcinoma (GSC) is an uncommon tumour; however, the incidence is not declining, so the tumour entity will be encountered in the years to come. Due to low diagnosis rate of early stage, GSC still has a poor prognosis. It is important for us to understand treatment principle. The treatment of choice for GSC should be the total removal of the gastric remnant including at least D2 lymphadenectomy. The pattern of lymph node metastases in GSC may differ from primary gastric carcinoma, as lymph node metastases have been reported in the jejunal mesentery and the lower mediastinum. Therefore, GSC may require a modified lymphadenectomy to include all important lymph node stations. After radical remnant gastrectomy, GSC has a prognosis not different from primary proximal gastric carcinoma.

Key words: gastric stump carcinoma, digestive tract reconstruction；lymph node dissection