摘要
目的探讨D2根治术联合脾切除对T3期胃上部癌的疗效及预后分析。方法1980年1月至2002年6月对613例T3期胃上部癌患者施行D2根治性手术，其中联合脾切除术者（切脾组）102例，未联合脾切除术者（保脾组）511例。对两组患者No．10、11淋巴结转移率、术后5年生存率和复发率及术后并发症的发生率和病死率进行对照分析。结果切脾组和保脾组No．10淋巴结转移率分别为23．5％、14．9％，差异具有统计学意义（P〈0．05）。两组No．11组淋巴结转移率相当。切脾组和保脾组术后5年生存率分别为39．8％、32．3％，复发率分别为55．9％、60．3％，差异均无统计学意义（P〉0．05）。切脾组中有No．10淋巴结转移的患者术后5年生存率与无转移的患者相似；切脾组和保脾组术后并发症的发生率和病死率分别为19．6％、4．9％和13．7％、3．1％，差异均无统计学意义（P〉0．05）。结论对于T3期胃上部癌患者，发生No．10淋巴结转移时，应施行联合脾切除术，彻底清扫No．10、11淋巴结，以提高疗效，减少复发。联合脾切除术不会增加患者术后并发症发生率和病死率。
Objective To analyze the efficacy and influence of D2 radical resection combined with spleneetomy in T3 cancer of upper stomach. Methods From January 1980 to June 2002, 613 patients with T3 cancer of upper stomach received D2 radical resection. Of these cases, 102 underwent simultaneous spleneetomy （splenectomy group） ,while 511 did not（ spleen-preserved group）. The metastatic rate of lymph nodes in splenic hiUum and along the splenic artery （No. 10, No. 11 ）, 5-year survival rates, recurrence rate, the postoperative complication rate and mortality rate were followed up and compared in the two groups. Results The metastasis rate of No. 10 was 23.5% for splenectomy group and 14. 9% for spleenpreserved group （ P 〈 0. 05 ）. No significant difference was found in No. 11 metastasis between the two groups. The 5-year survival rate of splenectomy group was 39. 8% , and was 32. 3% in spleen-preserved group （P 〉 0. 05 ）. The recurrence rate of splenectomy group was 55.9%, and was 60. 3% in spleenpreserved group （ P 〉 0. 05 ）. In the splenectomy group, the 5-year survival rates were similar between patients with and without No. 10 metastasis （ P 〉 0. 05 ）. The postoperative complication rate and mortality rate of the spleneetomy group were 19.6% and 4. 9% , and were 13.7% and 3.1% in the spleen-preserved group, respectively; and no significant difference was found between the two groups （P〉0. 05）. Conclusions D2 radical excision combined splenectomy should be recommended for stage T3 cancer of upper stomach when suspected with No. 10, No. 11 lymph nodes metastasis. Simultaneous splenectomy would not increase the postoperative complication rate and mortality rate.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2008年第9期681-684,共4页
Chinese Journal of Surgery
关键词
胃肿瘤
胃切除术
脾切除术
存活率
Stomach neoplasms
Gastrectomy
Splenectomy
Survival rate
