摘要
目的探讨胃癌根治术胰腺被膜及横结肠系膜前叶切除的短期疗效及癌转移相关因素。方法将288例拟行胃癌根治术患者按机械抽样法随机分为术中切除胰腺被膜及横结肠系膜前叶组（观察组）145例和术中不切除胰腺被膜及横结肠系膜前叶组（对照组）143例。对手术切除标本进行病理组织学检查，判断胰腺被膜及横结肠系膜前叶是否存在癌转移；同时分析胰腺被膜及横结肠系膜前叶癌转移与各临床资料间的关系；并对两组手术时间、术中出血量、清扫淋巴结总数、术后并发症进行比较。结果两组术中出血量、术后并发症发生率比较差异无统计学意义（P〉0．05）；观察组手术时间较对照组明显延长[（2．9±1．2）h比（2．3±0．9）h，P=0．036]，清扫淋巴结总数较对照组明显增多[（20．5±7．5）枚比（13．5±9．3）枚，P=0．005]。观察组胰腺被膜及，或横结肠系膜前叶存在癌转移12例（8．3％，12／145）。胃癌胰腺被膜及，或横结肠系膜前叶癌转移与肿瘤位置、临床分期、浸润深度、淋巴结转移程度有关（P=0．039、0．022、0．041、0．009），而与患者性别、年龄、肿瘤部位、肿瘤直径、病理分级无关（P〉0．05）。结论胃癌根治术应合理切除胰腺被膜及横结肠系膜前叶。
Objective To investigate the short-term effect of pancreatic capsule and anterior layer of transverse mesocolon in radical gastrectomy and analyze the Cancerometastasis factor. Methods A total of 288 gastric cancer patients were randomly assigned into two groups： 145 eases in observation group and 143 cases in control group. The patients only in observation group were given the pancreatic capsule and anterior layer of transverse mesocolon resecting during radical gastrectomy. The pancreatic capsule and anterior layer of transverse mesocolon were histologicaUy analyzed for metastasis. The data including the operation time, blood loss during operation,number of dissected lymph nodes and postoperative complications were analyzed in both groups. Results There were no significant differences between two groups in the blood loss during operation and postoperative complications （P 〉 0.05）. The operation time in observation group was longer than that in control group [ （2.9 ± 1.2） h vs. （2.3 ± 0.9） h, P = 0.036 ], the number of dissected lymph nodes in observation group was more than that in control group （20.5±7.5 vs. 13.5±9.3,P =0.005）. The metastasis to the pancreatic capsule and/or anterior layer of transverse mesocolon were diagnosed in 12 cases （8.3% , 12/145） in observation group. The metastasis to the pancreatic capsule and/or anterior layer of transverse mesocolon were found to be associated with tumor location, clinical staging, invasion depth and degree of lymph node metastasis （P= 0.039,0.022,0.041,0.009） ,but not with gender,age,tumor position,tumor diameter and pathological classification （P 〉 0.05）. Conclusions The resection is beneficial to the patients with advanced gastric cancer staging relatively late because of potential metastasis. The pancreatic capsule and anterior layer of transverse mesocolon should.be legitimately resected in radical gastrectomy.
出处
《中国医师进修杂志》
2012年第29期6-8,共3页
Chinese Journal of Postgraduates of Medicine
关键词
结肠系膜
胃切除术
胃肿瘤
胰腺
Mesocolon
Gastrectomy
Stomach neoplasms
Pancreas
