A Study On The Diagnosis And Surgical Treatment Of Gastric Stump Carcinoma (GSC)

[Objective]: To elucidate gastric stump carcinoma's clinical characteristics and study its occurrence mechanism, also investigate the pattern of lymph node metastasis and optimal surgery for patients with gastric stamp carcinoma. To emphasize the importance of early diagnosis and precaution for its prognose.[Methods]: The clinical data of 47 case admitted during the period from January 1985 to January 2003 are analyzed restrospectively.[Resu I ts] Gastric stamp carcinomas often rise after subtotal gastrectomy with Billroth II and males is common. The focus lies to gastric mucosa adjacent to anstomotic stoma. In this group of cases, pathological stage I ,II,IIIandVI is3.6.18.20,Among them,27caes undergo curative resection, and the metastasis rates of lymph node are as following: 55.6%. In group 1, 30.0%. In group 2, 78.1% In group 3, 43.8%. In group 4, 21.3% in group 7, 37.5%. In group 8, 41.2% in group 9, 61.5%. In group 10, 71.4%. In group 11, 32.2%. In group 12, 14.3%. In group 13, 16.6%. In group 14, 13.3%. In group 15, 20.0%. In group16, 15.8%. In jejunal mesentery. All seven patients undergoing non-resection only died within one year, and the 1.3.5-yeat survival rates of patient(n=24) with curative resection were significantly better than those of patients(n=l l)with palliatine gastrectomy.[Conclusions]: (1)Proliferative activity of duodenal reflux should be responsible for the high incidence of patients with gastric cancer in the Long-standing gastrectomy patients. In order to decrease the incidence of stump carcinoma effectively, it seems reasonable to perform reconstruction procedures (e.g, B-I 或 Roux-en-Y anastomosis) for those with gastrectomy.(2)The five-year survival rate shows no different between patients with gastric stump carcinoma and primary gastric cancer after resection and adequate lymphadenectomy,while it's better than those of patient with palliatine gastrectomy.(3)patient with gastric stump carcinoma can gain better prognosis by undergoing curative resection with adequate lymphadenectomy and early diagnose and precaution...