頁籤選單縮合
題名 | Spontaneous Perforation of Castric Cancer=自發性胃癌穿孔 |
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作者 | 陳漢文; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19920300、19920400 |
卷期 | 25:2 民81.03-04 |
頁次 | 頁1102-1108 |
分類號 | 416.243 |
語文 | eng |
關鍵詞 | 自發性胃癌穿孔; |
中文摘要 | 隨著內視鏡的廣泛使用,胃癌穿孔巳日漸減少。自1979至1988年十年間,高雄醫學院附設醫院共發現有9例胃癌穿孔,佔同時期胃癌手術的2.81%(9/320)。患者皆以腹部急症及胃腸道穿孔而接受緊急手術。術前及術中的診斷率為55.6%及88.9%。手術方式包括簡單縫合合併大網膜包裹及胃切除術。術後的平均存活期為10.3月。本文對胃癌穿孔的臨床表徵、診斷方法、病理分類、手術方式及預後作分析。我們發現(1)因癌細胞易種入腹腔內,胃癌穿孔的預後差。(2)胃癌穿孔率與腫瘤的大小,肉眼型式無關。(3)高淋巴腺轉移率,分化良好的腺癌及胃竇部腫瘤是胃癌穿孔的特徵。(4)由於緊急胃切除術之死亡率及罹病率低,因此胃切除術是胃癌穿孔手術的最佳選擇。 |
英文摘要 | Nine patients all having the spontaneous perforation of gastric adenocarcinoma and being treated from 1979 to 1988 are reviewed. The incidence of this severe complication was 2.81% among 320 gastric cancers. The clinical presentation included vague epigastralgia, gastrointestinal bleeding and weight loss. The acute abdominal pain and signs of peritonitis were common physical findings. All the patients were found to have the subphrenic free air on roentgenograms. The laparotomies were performed on all patients, with the gastric resection occupied with 66.7% of the cases. The mean survival time of these patients was 10.3 months (range 2-23). Our analysis showed: (1) the poor prognosis in the perforation of the gastric cancer was due to an advanced stage and intraperitoneal seeding; (2) the frequency of perforation was not predictable from the tumor size and the gross type; (3) the predominant pathological findings included antrum involvement, well-differentiation, and the metastasis of regional lymph node; and, (4) an immediate gastrectomy could be performed with an acceptably low mortality and morbidity rate. Although specific operative procedures should be determined by intraoperative findings and general conditions, a curative or palliative resection is the best choice for the perforated gastric cancer. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。