| Objective:gastric stump arcinoma(USC)is a new cancer of remnant stomach after gastric operation,which initially refers to a new cancer that occurs in the remnant stomach more than 5 years after the operation of the benign disease,and then gradually extends to which new cancer of remnant stomach,10 years after operation of gastric cancer.The purpose of this article is to analyze and discuss the clinical characteristics of gastric stump cancer patients,enhancing the understanding of this disease.Methods:the data of 46 cases of gastric stump cancer treated in local hospital from 2014 to 2016 were analyzed retrospectively.The age,sex,the first operation method,the reason of the first operation,the time interval from the first operation to the final gastric stump cancer diagnosis,the clinical manifestations,the size of the tumor,the depth of invasion and metastasis were recorded,postoperative recovery and etc.SPSS19.0 statistical software was used to analyze the results.Among them,the pathological classification of tumors(PTNM)is based on the seventh edition of Union International Center of Cancer(UICC).1.In all patients,there were 11 cases(24%)of previous malignant tumors;34 cases(76%)of previous benign lesions;in the Borrmannn classification of gastric stump cancer’s gross type,15 cases of type Ⅰ(33.3%),23 cases of type Ⅱ(51.1%);1 case of type Ⅲ(2.2%)and 6 cases of missing data(13.3%).2.All patients who were diagnosed with gastric stump cancer,40 males(89.1%)and 5 females(10.8%),the ratio of males to females is about 8:1,the age of onset ranges from 54 to 89 years,with an average age of 68.8 years.The interval between the first operation and the diagnosis of gastric stump cancer ranges from 5 to 49 years.3.Among the people whose first disease is malignant gastric stump cancer,there are 10 males and 1 females;the ratio of males to females is about 10:1;the age of onset ranges from 62 to 76 years old,with an average age of 61.7 years.4.Among the people whose first disease is benign gastric stump cancer,there are 30 males and 4 females;the ratio of males to females is about 7:1;the age of onset ranges from 54 to 89 years old,with an average age of 71.6 years.5.The patient’s previous surgical methods:9 cases of distal gastrectomy;2 cases of proximal gastrectomy;30 cases of partial gastrectomy;4 cases of missing surgical records.6.Of these patients,41 patients underwent radical surgical resection,40 patients underwent laparotomy surgery,only 1 patient underwent laparoscopic operation,and 1 case of combined spleen+pancreatic body and tail resection,and 1 case of combined resection of part of the left liver.The other 2 cases underwent exploratory laparotomy,during which a large number of peritoneal metastases were found,or the nodular cancer was closely related to the surrounding organs,which could not be removed by operation,so they decided to close the abdomen directly.2 patients underwent conservative treatment considering the advanced stage of the disease without surgery.7.45 cases of gastric stump cancer patients were in clinic pathological stage Ⅳ,Ⅲ,Ⅱ and Ⅰ,and the quantity are 6 cases,20 cases,9 cases and 10 cases respectively.8.Other auxiliary examinations:there were 13 cases in CEA increasing,13 cases in CA199 increasing,and 7 cases in CA123 increasing.9.Tumor size,invasion depth and metastasis:40 patients with tumor size recorded,tumor diameter ranges from 2 to 14 cm,according to the largest diameter of the tumor,they were divided into three groups for statistics.There are 11 cases according to the maximum diameter of the tumor ≤3 cm,9 cases according to the maximum diameter of the tumor ranges from 3-5 cm,and 20 cases according to the maximum diameter of tumor≥20cm.10.The average time between previous benign lesions of the patients and the previous operation was 369.4 months,the average time between previous malignant lesions of the patients and the previous operation was 159.0 months,which has the statistical significance(P<0.05).11.Among the 23 recorded patients with previous benign lesions,the average eating time was 6.9 days;the average hospital stay was 14.4 days,9 recorded patients with previous malignant lesions,the average eating time was 7.1 days,the average hospital stay was 13.3 days.There was no difference between the two and no statistical significance(P>0.05).However,considering that patients with previous malignant diseases are older than patients with previous benign diseases,this conclusion is doubtful. |
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