위전절제술 및 확대 위전절제술에 관한 임상적 고찰
Clinical Evaluation of Total Gastrectomy and Extended Total Gastrectomy for Gastric Cancer
대한암학회지 1989년 21권 1호 p.93 ~ 100
조마해, 박재감, 안윤옥,
소속 상세정보
조마해 ( )
서울대학교 의과대학 외과학교실
박재감 ( )
서울대학교 의과대학 외과학교실
안윤옥 ( )
서울대학교 의과대학 외과학교실
KMID : 0360319890210010093
Abstract
During 16 years from Jan. 1970 to Dec. 1986, total gastrectomy and extended total gastrectomy were performed in 566 patients.
The results are as follows:
1) Gastrectomy was performed in 2891 out of 3791 patients (76%) who underwent operation.
2) Total gastrectomy and extended total gastrectomy were performed in 566 patients (19%) of them.
3) The most frequent site of primary gastric cancer was the body (40.5%), followed by the cardia and fundus (24.4%), diffuse infiltration of gastric wall (18.1%) and antrum (17.0%).
4) In the cases of advanced carcinoma, the most common Borrmann type was Type Ⅲ (55.8%), followed by Type IV (18.1%), Type Ⅱ (17.0%) and Type Ⅰ (3.4%).
5) Early gastric cancer was 26 cases (5.7%).
6) In the pathologic findings, the most common type was adenocarcinoma (68.9%), followed by mucinous cell (9.7%), signet ring cell (8.6%) and undifferentiated carcinoma (5.7%).
7) In the staging of cancer according to TNM postsurgical-pathologic stage group, stage I was 4. 4%, stage Ⅱ 17.4%, stage Ⅲ 78.2%.
8) In the extended total gastrectomy, partial hepatectomy was performed in 10 cases (8.4%) and transverse colectomy was performed in 10 cases (8.4%) in addition to pancreaticosplenectomy.
9) Overall operative mortality was 3.8% and no significant difference of operative mortality was found between total and extended total gastrectomy.
10) The expected 5 YSR, according to Cohort life table, was 45% in total gastrectomy and 24% in extended total gastrectomy. In the total gastrectomy patients, 5 YSR of stage Ⅰ , Ⅱ, Ⅲ were 100%, 68% and 36%, respectively. In the extended total gastrectomy patients, 5 YSR of stage Ⅱ and Ⅲ were 48% and 16%, respectively.
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