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[目的]探讨复发性胃癌再次行外科手术治疗的意义。[方法]回顾性分析1990年1月~2005年12月收治的103例复发性胃癌的临床资料。[结果]103例胃癌,复发局限于残胃45例,首次术后2年内复发61例。全组再手术切除54例,其中根治性切除43例,姑息性残胃切除11例,合并联合脏器切除25例。全组再次手术后1、3、5年生存率分别为71.2%、21.6%和9.5%,其中根治性残胃切除术后1、3、5年生存率分别为86.2%、49.1%和19.5%,中位生存期32.0个月;姑息性切除术后1、3、5年生存率分别为45.5%、10.0%和0,中位生存期15.0个月;未切除患者均于1年内死亡。[结论]残胃局部复发癌以残胃、吻合口局部复发及邻近器官浸润为主,具有较高的切除率,应积极行再手术治疗。
[Objective] To investigate the significance of surgical treatment again for recurrent gastric cancer. [Methods] The clinical data of 103 patients with recurrent gastric cancer admitted from January 1990 to December 2005 were analyzed retrospectively. [Results] 103 cases of gastric cancer, recurrence confined to the remnant stomach in 45 cases, the first postoperative recurrence in 61 cases within 2 years. Reoperation of the whole group of 54 cases, of which 43 cases of radical resection, palliative resection of the stomach in 11 cases, combined with organ resection in 25 cases. The 1, 3, 5-year survival rates after reoperation in the whole group were 71.2%, 21.6% and 9.5% respectively. The survival rates at 1, 3 and 5 years after radical gastrectomy were 86.2%, 49.1% and 19.5% , And the median survival time was 32.0 months. The 1, 3, 5-year survival rates after palliative resection were 45.5%, 10.0% and 0, respectively. The median survival time was 15.0 months. [Conclusion] The local recurrence of residual gastric stump is mainly caused by the local recurrence of gastric remnant and anastomosis and the infiltration of adjacent organs. It has a high resection rate and should be reoperated actively.