摘要
目的研究全胃切除术式在胃底贲门部癌治疗中的意义。方法1998年5月至2007年5月兰州大学附属白银医院普外科手术的118例胃底贲门部癌患者，行全胃切除术（A组）65例。近端胃切除术（B组）53例。对2组患者浸润程度、淋巴结清扫以及术后并发症发生率和生存率进行对比分析。结果A、B组淋巴结清扫个数分别为（19．4±3．9）个和（15．2±2．6）个（P〈0．05），淋巴结转移率为40．8％（514／1261）、54．8％（441／806），A组No．5、No．6淋巴结转移率为15．4％（10／65）、12．3％（8／65）。A、B组并发症发生率分别为7．7％（5／65）、13．2％（7／53）。A、B组1、3、5年生存率分别为63．1％、46．2％、30．8％和66．0％、36．9％、18．5％。A组3、5年生存率高于B组（P均〈0．05）。结论全胃切除术更利于胃周淋巴结的清扫，不增加并发症发生率，并提高I、Ⅱ、Ⅲ期患者3、5年生存率。
Objective To explore the value of total grastrectomy in gastric cardia and fundus carcinoma. Methods 118 cases with cardiac cancer were treated by surgical treatment, those patients were admitted between May 1998 and May 2007 in Affiliated Baiyin Hospital of Lanzhou University. Of them,65 cases were treated by total gastractomy （group A）,and 53 cases were treated by proximal gastractomy（ group B） . The degree of invasion , lymph node dissection, postoperative complication rate and survival rate were compared. Results The average number of lymph node were 19.4 ± 3.9 and 15.2 ± 2.6 （ P 〈 0.05 ）, respectively. The occurrence of lymph node metastasis were 40.8% （514/1261） and 54.8% （441/806）, respectively. Of them, the occurrence of metastasis of lymph node of No. 5 ,No. 6 in group A were 15.4% （ 10/65 ） and 12.3% （ 8/65 ）, respectively. The postoperative complication rate were 7.7 % （5/65） and 13.2% （7/53）. The 1,3, and 5 year survival rates were 63.1% ,46.2%, 30.8 % in group A and 66.0% ,36.9% ,18.5% in group B, with significant differences beteen two groups in 3, 5 year survival rates（P 〈 0.05）. Conclusion The way of total grastrectomy is better in cleaning lymph node than that of proximal gastrectomy, and dosen＇t increase the postoperative complication rate but improves 3-year and 5-year survival rates in cases with cardiac cancer of Ⅰ , Ⅱ, Ⅲ stage.
出处
《中国综合临床》
2009年第6期644-646,共3页
Clinical Medicine of China
