查詢結果分析
來源資料
相關文獻
- Proximal Third Gastric Adenocarcinoma: Results of Total Gastrectomy by General Surgeons and Analysis of Prognostic Factors
- 胃癌術後引發之慢性腹瀉中醫治療
- Intraluminal Mucin Pool in Mucinous Gastric Adenocarcinoma: A Case Report
- 胃癌之流行病學特徵及危險因子
- Dispute of Extended Lymph Node Dissection for Gastric Cancer
- 源自胃癌的克魯根堡氏瘤:十年臨床經瞼
- 胃癌化學治療之進展
- Pregnancy Associated with Gastric Carcinoma
- 20-MHz Ultrasonic Probe to Identify Early Gastric Cancer Suitable for Endoscopic Mucosal Resection
- 胃癌復發併吸收不良症候群
頁籤選單縮合
題名 | Proximal Third Gastric Adenocarcinoma: Results of Total Gastrectomy by General Surgeons and Analysis of Prognostic Factors=近端三分之一胃癌施行全胃切除手術後之治療成績和預後分析 |
---|---|
作者 | 王嘉修; 趙子傑; 薛綏; 鄭隆賓; 詹益銀; 陳訓徹; 黃燦龍; 陳敏夫; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 29:5 民85.09-10 |
頁次 | 頁382-390 |
分類號 | 416.243 |
關鍵詞 | 胃癌; 全胃切除手術; Proximal third gastric cancer; Cardia; Total gastrectomy; Prognostic factors; |
語文 | 英文(English) |
中文摘要 | 自1986年至1992年之間有連續121個患近端三分之一胃癌的病人,接 受全胃切除手術。本文旨在評估此治療的結果和預後因子。這些病人都由一般外 科醫師主刀,大多經開腹途徑,必要時藉助食道裂孔之切開進行縱隔腔部份的操 作,故需要開胸僅有14位(11.6)。共有65人(53.7)接受根治性切除手術,包含第 二階淋巴結廓清術和無癌的切除邊緣。手術併發症率是I6.5,其中有5人(4.1)死 亡。五年概括存活率是33.5,和其他報告結果相近。多項變數分析確立遠方轉移、 食道侵犯、漿膜侵襲和淋巴結轉移四項是影響存活的最重要預後因子。食道斷端 陽性殘餘的病人共有18例包括根治性切除後才發現的2例和本屬非根治性切除 的16例。雖然陽性食道斷端於單項變數分析中呈現有意義之預後因子,但於多 項變數分析顯示非獨立因子。我們結論認為於遠方轉移和侵犯食道之前早期發現 是改善預後的重要關鍵。近端三分之一胃癌的病人大部份可經由開腹途徑來施行 全胃切除手術,縱隔腔部份的操作可藉助食道裂孔之切開擴大術野,減少開胸的 需要性。 |
英文摘要 | Surgical results and prognostic factors were studied in a total of a consecutive 121 patients following total gastrectomy, without routine thoracotomyfor proximal third gastric adenocarcinoma, with surgery performed between 1986 and 1992. Laparotomy was used as the first approach in all patients. Exposure of lower mediastinum was helped by incising or resectingthe diaphragm around the esophageal hiatus; therefore thoracotomy wasperformed in only 14 (11.6) patients. Curative resection requiring lymphnode dissection up to the second echelon (D2) and free resection margin wasdone for 65 (53.7) patients. Positive esophageal margin was left in 18 (14.9) patients who, except for two, underwent palliative resection. Thepostoperative complication rate was 16.5 with operative mortality in fivepatients (4.1). The overall cumulative five-year survival rate was 33.5.Multivariate analysis indicated that the most important prognostic factorswere distant metastasis, esophageal invasion, serosal invasion and lymphnode metastasis. Positive resection margins were not independent factors.It was concluded that earlier detection before distant metastasis andesophageal invasion is important in improving the results of total gastrectomy for proximal third gastric cancer and a comparable result can beachieved without routine thoracotomy. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。