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      • 절제불능 위암의 임상적 고찰

        전갑승,장일성 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

        This study was a review and clinical analysis of 58 cases with unresectable stomach cancer among 293 cases of stomach cancer who received operation, of 344 patients who were diagnosed to stomach cancer on the Department of Surgery, Chungnam National University Hospital for 3years and 3months from 1st, june, 1986 to 31st, August, 1989. The results were obtained as follows: 1. The most frequent age group of unresectable stomach cancer was the 6th decade and male to female ratio was 4.3:1 and duration of symptom to operation was predominated in the group of less than 3 months with 28 cases (48.2%) and mean symptom duration was 10.9 months. 2. The most common symptoms in order of frequency were epigastric pain & discomfort(98.3%), indigestion (74.1%), nausea and vomiting (65.5%), anorexia (62.1%) and the most common physical findings were epigastic tenderness (91.4%), palpable epigastric mass (31.0%) and cachexia (24.1%), and the patients with the weight loss more than 5.0㎏ were 24 cases (41.4%). 3. The patients with anemia (hemoglobin; loss than 10.0gm%) were 15 cases (25.9%), and with abnormal albumin level than 3.5gm% were 22 cases (37.9%). Serum AFP & CEA were measured on 33 and 42 cases of 58 cases with unresectable stomach cancer, respectively and patients with abnormal high S-AFP and S-CEA range were 6 cases(18.2$) and 18 cases (42.8%), respectively. 4. The most common site on the tumor was pyloroantral region of lesser curvature 31 cases (53.3%), and macroscopic size of the tumor in order of frequency was adult fist size (44.8%), child fist size (41.5%), and in the pathologic findings, all cases were adenocarcinoma, especially moderate differentiated type; 11 cases (40.7%). 5. The operative procedures performed for our cases; exploratory-laparotomy and biopsy 26 cases (44.8%); gastrojejunostomy 24 cases (41.5%); feeding gastrostomy or feeding jejunostomy 5 cases (8.6%); simple closure & gastrojejunostomy 2 cases (3.4%); sigmoid loop colostomy 1 case (1.7%). 6. The most common causes of unresectability of the tumor in order of frequency were due to direct invasion and/or mastastasis to pancreas 26 cases (44.9%), both pancreas and hepatobiliary 18 cases (32.2%), hepatobiliary 10 case (17.1%). So, unresectability ratio related to pancreas and hepatobiliary was 44 cases (76.1%) and 28 cases (48.3%), respectively.

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