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胃癌의 臨床的 觀察

Clinical Study of Stomach Cancer

대한외과학회지 1970년 12권 4호 p.13 ~ 22
김영일,
소속 상세정보
김영일 (  ) - 우석대학교 의과대학 외과학교실

Abstract


This clinical study is a review of our experience with 295 cases of stomach cancer admitted to Dept. of General Surgery of Woo Sok University Medical College Hospital during the period from Jan. 1969 to Dec. 1969.
the results are as follows:
1) The percentage ratio of stomach cancer to the total number of admitted patients (3865 cases) in Dept. of General Surgery during the above mentioned period was 7.63%.
2) Age incidence of stomach cancer were most high in the age group of 51∼60, and their number of patients were 128 (43.39%).
The ratio of sex distribution was 2.6 : 1 with 213 males and 82 females.
3) The most patients had hte duration of Symptoms less than I year of illness (60.32%).
4) Subjective complaints in order of frequency were as follows: Epigastric pain and discomfort 192 cases (65.08%), Indigestion 158 cases (53.55%), Anorexia 88 cases (29.83%) and Abdominal distension 72 cases (24.40%).
Objective Signs in order of Frequency were as follows: Palpable mass 187 cases (63.38%), Vomiting 163 cases (55.25%), Weight loss 56 cases (18.98%), Tenderness 39 cases (13.22%).
5) 106 cases of G.I trouble (35.93%), 58 cases of peptic ulcer (19.66%), 36 cases free of symtoms (12.20%) and 41 cases of unkonwn eitology (13.89%) were recorded as past history.
6) Laboratory examination of serum total protein was done in 134 cases: 36 cases of over 6.0 gm% (26.86%), 29 cases of 5.0∼6.0 gm% (21.64%), 61 cases of 4.0∼5.0 gm% (45.53%) 8 cases of below 4.0 gm% (5.97%).
7) There were 129 cases (74.57) who had filling defect among X-ray checked 173 cases.
8) Preoperative diagnosis of stomach cancer was made before surgery was confirmed in 69.84% of all cases.
9) The tumors were resected in 157 cases (71.02%). Sub-total gastrocetomy with Gastrojejunostomy was done in 137 cases (61.99%) for the operative procdure of choice.
10) The location of tumors (221 cases in explored abdomen) was as follows: 126 cases (57.02%) at antrum and pylorus, 52 cases (23.53%) at lesser curvature, 13 cases (5.88%) at cardia and fundus.
Microscopic pathological findings were studied on 184 cases, and their analytic findings were as follows: Adenocarcinoma 104 cases (56.52%), Diffuse infiltrating type 35 cases (19.02%), Mucinous type 17 cases (9.23%), Papillary type 12 cases (6.52%), Medullary type 8 cases (4.34%), Scirrhous type 5 cases (2.71%) and lymphosrcoma 3 cases (1.63%).
The most frequent site of metastasis of cancer was regional lymphnodes which were involved in 153 cases (69.23%). Metastatic sites in the intra-abdominal parenchymatous organ were liver in 44 Cases (34.84%), Pancreas in 24 cases (10.84%) and Spleen in 12 cases (5.42%).
11) There were 189 cases (85.53%) who stayed in the hospital within 3 weeks.
Wound infection was one of the most common complications in the surgery of gastric cancer (32 cases).
12) Over-all operative death was observed in 8 cases (3.62%).

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