Clinicopathological Characteristics of Remnant Gastric Cancer After a Distal Gastrectomy
Clinicopathological Characteristics of Remnant Gastric Cancer After a Distal Gastrectomy
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DOI：
10.1007/s11605-009-1090-5
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发表时间：
2010-02-01
影响因子：
3.2
通讯作者：
Yamaue, Hiroki
中科院分区：
文献类型：
--
作者：
Ojima, Toshiyasu;Iwahashi, Makoto;Yamaue, Hiroki
残胃癌患者的生存率与未切除胃的癌症相比是不利的。然而，当根治性切除RGC时，两组之间的生存率没有显著差异。为探讨影响RGC根治性切除的临床病理因素，对1994年1月1日至2009年3月31日收治的38例RGC患者进行回顾性分析，原发病为胃癌21例（55.3%），良性病变17例（44.7%）。第一次胃切除术后胃重建术式为Billroth I型28例（73.7%），Billroth II型10例（26.3%）。共有31例患者接受了剖腹手术。20例患者接受了根治性切除术，4例患者接受了姑息性切除术，7例患者接受了非切除性手术。共有7例患者接受了早期胃癌的内镜切除术，所有患者均接受了根治性切除。单因素和多因素Logistic回归分析，以确定影响RGC根治性切除的临床病理和背景因素。多因素分析显示，首次胃切除术后每年随访一次内镜检查是根治性切除的独立因素（p = 0.016;比值比35.3），首次胃切除术后每年随访一次内镜检查可能与改善RGC患者的预后有关。
The survival rate of patients with remnant gastric cancer (RGC) is unfavorable in comparison to that of cancer in the nonresected stomach. However, when RGC is curatively resected, no significant differences have been reported between both groups in regard to survival. The aim of this study is to analyze the clinicopathological factors influencing a curative resection of RGC.Thirty-eight consecutive patients with RGC from January 1, 1994 through March 31, 2009 were enrolled in this retrospective study.Their primary diseases were gastric cancers (21; 55.3%) and benign diseases (17; 44.7%). The type of the reconstruction methods of first gastrectomy were Billroth I (28; 73.7%) and Billroth II (10; 26.3%). A total of 31 patients underwent a laparotomy. Twenty patients underwent a curative resection, four patients underwent a palliative resection, and seven underwent a nonresective operation. A total of seven patients underwent an endoscopic resection for early gastric cancer, and all patients received a curative resection. Univariate and multivariate logistic regression analyses were performed to identify the clinicopathological and background factors influencing a curative resection of RGC. A multivariate analysis revealed only an annual follow-up endoscopic examination after the initial gastrectomy to be an independent factor for a curative resection (p = 0.016; odds ratio, 35.3).An annual follow-up endoscopic examination an after initial gastrectomy may be related to improving the prognosis of patients with RGC.