CAJ | 학술논문

目的探讨全胃切除术在胃恶性肿瘤治疗中的作用。方法回顾性分析113 例胃恶性肿瘤全胃切除术的临床资料。结果根治性全胃切除97例，姑息性全胃切除16例，合并横结肠、脾、胰头、胰尾部、肝切除19例。消化道重建方式有：食道空肠Roux-en-Y吻合26例，食道空肠Braun吻合19例，p型空肠袢代胃Roux-en-Y吻合68例。术后出现并发症15例，其中胰瘘1例，吻合口瘘3例；手术死亡2例。术后随访86例，随访率76％。根治性全胃切除、联合脏器切除和姑息性全胃切除术后1，3，5年生存率分别为：77.9％，45.7％，37.2％；88.8％，55.5％，33.3％和80％，0%，0％。结论严格掌握手术适应证，合理的联合脏器切除，采用全胃切除治疗胃恶性肿瘤可取得满意疗效。
목적탐토전위절제술재위악성종류치료중적작용。방법회고성분석113 례위악성종류전위절제술적림상자료。결과근치성전위절제97례，고식성전위절제16례，합병횡결장、비、이두、이미부、간절제19례。소화도중건방식유：식도공장Roux-en-Y문합26례，식도공장Braun문합19례，p형공장번대위Roux-en-Y문합68례。술후출현병발증15례，기중이루1례，문합구루3례；수술사망2례。술후수방86례，수방솔76％。근치성전위절제、연합장기절제화고식성전위절제술후1，3，5년생존솔분별위：77.9％，45.7％，37.2％；88.8％，55.5％，33.3％화80％，0%，0％。결론엄격장악수술괄응증，합리적연합장기절제，채용전위절제치료위악성종류가취득만의료효。
Objective　To investigate the effect of total gastrectomy for gastric malignancy(GM). Methods　The clinical data of total gastrectomy in 113 patients with GM were analysed retrospectively. Results　Radical total gastrectomy was performed in 97 cases, palliative total gastrectomy in 16 cases, combined with resection of head or tail of pancreas, splenectomy, transverse colectomy or parital hepatectomy in 19 cases. Reconstruction of digestive tract : Roux-en-Y esophagojejunostomy in 26 cases, Braun esophagojejunostomy in 19 cases, Roux-en-Y jejunal p-type anastomosis in 68 cases, Postopterative complications occurred in15 cases,including pancreatic fistula in one cases,anastomostic leakage in 3; operative death was happened in 2 cases.　86 patients (76%)have been followed up, the postoperative 1-,3-,5-year survival rate in radical total gastrectomy, combined resection organs and palliative total gastrectomy was 77.9％,45.7％,37.2％;88.8％,55.5％,33.3％; and 80％,0％,0％ respectively. Conclusions　The effect of total gastrectomy for gastric malignancy can be successful, if the indications are stricted and combined with rational viscers resection.