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| 題 名 | 對賁門區外末期胃癌之外科手術治療 |
|---|---|
| 作 者 | 吳誠中; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 21:6 1988.11[民77.11] |
| 頁 次 | 頁665-671 |
| 分類號 | 416.243 |
| 關鍵詞 | 外科手術治療; 賁門區外末期胃癌; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 胃腺為多發生在胃遠端,賁門區較少。台中榮總一般外科,回溯民國74年6月前賁門區外胃腺癌患者共296例,其中159例(53.7%)手術時已無法完全清除病灶。此159例中共70例可作姑息的切除原發腫瘤,包括63例達端胃次全切除,5例胃全切除及2例近端胃次全切除。另63例因有消化道阻塞症狀而原發腫瘤無法切除而作改道手術;有26例則只剖腹探查。共6例術後死亡,死亡率是3.77%。共135例可接受追蹤至76年9月止,對賁門區外末期胃癌病患,我們發現原發腫瘤可切除者,術後之存活期較長;而男女性別、患者手術時之年齡不影響其預後。胃腸之改道手術只能暫時改善阻塞症狀,但無法延長存活期。肝臟有否轉移並不影響原腫瘤之姑息切除;但若腫瘤較高位者及明顯有惡性腹水者,其原發腫瘤可切除之機會不多。對於賁門區外末期胃癌患者我們建議在其一般狀況許可時,仍應儘可能手術切除原發病灶,可以改善其生活品質並延長其壽命。 |
| 英文摘要 | Gastric carcinoma usually occurred at distal stomach. There were 296 patients of gastric carcinoma outside the cardiac region operated in the Section of GeneraJ Surgery at VGH -Taichung before June 1985, Non-radical operation was applied in 159 cases (53.7%). The operations were (1) 70 cases of palliative gastrectomy including 63 cases of distal subtotal gastrectomy, 5 cases of total gastrectomy and 2 cases of proximal subtotal gastrectomy; (2) 63 cases of bypass surgery to relieve symptoms of gastrointestinal obstruction by cancer; and (3) 26 cases of Japarotomy only. Six cases (3.77%) died postoperatively. One hundred and thirty-five cases had been followed up till September 1987. The patients with primary tumor being resected had prolonged survival. The primary tumors were usually unresectable when patients had malignant ascites or proximal lesions, while hepatic metastasis was not an indication of unresectablility. Bypass surgery could only temporarily relieve the gastrointestinal obstruction symptoms and didn't influence the prognosis. Palliative gastrectomy is thus recommeded for patients with advanced gastric cancer, whenever possible, to improve life quaJity and to prolong survival time. |
本系統中英文摘要資訊取自各篇刊載內容。