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한국인 위암수술후 그 원격성적에 관한 임상적 고찰

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 Clinical observation of late result after operation in carcinoma of the stomach in Koreans 
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[영문] In spite of that there have been much trials to combat with cancer applying newly discovered anticancer drug and radioisotope recently, the choice of radical treatment of carcinoma of the stomach still relies upon early surgical resection. Present studies attempt to clarify the relationship between the 5 year survival rate and the type of operation and metastasis to regional observation of operability and resectability, ratio of male and female, duration of subjective symptoms, age incidence for the stomach cancer were studied. Among 451 cases operated during 8 years from Jan. 1963 to Dec. 1970, 238 cases(52.8%) were able to follow up for postoperative survival rate. In calculating 5 years survival rate, only 73 cases(39.3%) out of 186 cases those who were operated on before Dec. 1966, were selected and they were all able to do follow up study completely. In addition to the above 679 cases operated for 16 years from Jan. 1955 to Dec. 1970 were observed for operability and resectability, the age, sex incidence, duration of subjective symptoms of the stomach, cancer clinically. The operative results may be summerized as follows: operability 47.5% and resectability 28.6%, explo-laparotomy and unresected cases 18.9%. Peak incidence was in the age group of 50 to 59 and it was 33.5% and male and female ratio was as 4 to 1, outnumbered by male. The subjective complaints in order of frequently were as follows: upper abdominal pain and discomfort(76.0%), indigestion(63.8%) predominantly. There were 18 five year survival cases, all of them except one total gastrectomized cases were belonged to the subtotal gastrectomized group. The percentage ratio of 5 year survivals to the total operated cases was 24.7%. Five year survival rate among all gastrectomized cases 29% in the regional lymph node metastasis group, while 38.5% in negative cases. In the all subtotal gastrectomized gruop, 5 year survival rate was 28.8% and in the cases of positive regional lymph node metastasis 26.1% and in negative 38.5%. There was one 5 year survival of three operated in the total gastrectomized group. In the unresected group two thirds of the cases died within 6 months and only one case survived for 3 years. The mortality after gastrectomy was 47.5% in one year postoperatively nd group lived more than 3 years after gastrectomy was had more chances for 5 years more. The mortality of unresected group was 68.4% in 6 months and most died within 1 year. As the influencing factors in the end results of surgical resection of carcinoma of the stomach, better end results were proved to be obtained in the group of shorter duration of the symptoms, negative regional lymph node metastasis.
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