臨牀消化器内科 Vol.12 No.13(10)


特集名 残胃の癌
題名 手術治療と成績
発刊年月 1997年 12月
著者 小熊 英俊 東京女子医科大学消化器病センター外科
著者 鈴木 博孝 東京女子医科大学消化器病センター外科
【 要旨 】 1968~1993年に経験した幽門側胃切除術後残胃の230例を対象に,その外科治療と治療成績の検討を行った.残胃の癌の特徴は,周囲臓器への直接浸潤例が多く非切除となることが多いことと,切除例においては進達度se以上におけるn3,n4症例が多く,根治度Cとなることが多いことであった.総合的進行程度別の生存率の検討ではstageIIIaまでの症例は初発上部胃痛と同等の治療成績であるが,stageIIIb以上では悪く,進行例においては周囲臓器の合併切除とともに拡大リンパ節郭清が必要と考えられた.
Theme Carcinoma in Remnant Stomach
Title Results of Surgical Treatment for Carcinoma of the Remnant Stomach
Author Hidetoshi Oguma Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
Author Hiroyoshi Suzuki Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
[ Summary ] From 1968 to 1993, 230 patients diagnosed as having carcinoma of the remnant stomach after distal gastrectomy were included in this study. There was a high incidence of advanced disease invading adjacent organs. Among the patients who underwent resection, distant lymph node metastasis (n3 and n4) was responsible for non-curative resection (curability C) in those with se cancer. In stage I-IIIa. survival of patients with carcinoma of the remnant stomack was similar to that of patients with upper third gastric carcinoma, but worse than that of patients with upper third gastric carcinoma in stage IIIb-IVb. Combined resection of the adjacent organ and extended lymphadenectomy might be necessary for advanced diseases.
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