79例老年胃癌的临床治疗分析

目的 探讨老年胃癌的临床病理特征、围手术期处理及手术治疗的相关问题.方法 回顾性分析2004年1月至2011年7月收治的79例60岁以上老年胃癌患者临床资料.结果 肿瘤部位以贲门胃底部最常见(29例);79例患者中有73例患者接受手术治疗,其中行根治性胃切除术33例,姑息性胃切除术29例,胃空肠吻合术4例,剖腹探查术7例.术后TNM分期为Ⅰ期4例,Ⅱ期7例,Ⅲ期20例,Ⅳ期42例.术前并存慢性疾病者52例,术后有28例患者出现并发症.结论 老年胃癌患者病理分期多为Ⅲ、Ⅳ期,术前多伴有慢性疾病,手术方式应根据病情而定,加强围手术期处理,可提高手术切除率,减少术后并发症的发生.

Analysis of the Clinical Treatment of 79 Cases of Elderly Gastric Cancer

Objective To explore the pathological manifestations,the perioperative management and the surgical treatment of elderly gastric cancer.Methods The clinical data of 79 cases of elderly gastric cancer(gathered during January 2004 to July 2011,from patients aged over 60) were analyzed retrospectively.Results Cancer was most commonly found at the fundus or cardia(29 cases).73 patients of the 79 cases were treated with operation,of which 33 were radical gastrectomy,29 were palliative gastrectomy,4 were gastrojejunostomy,and 7 were exploratory laparotomy.After the surgical treatment,the TNM of 4 cases were in StageⅠ,7 in stage Ⅱ,20 in stageⅢ and 42 in stage Ⅳ.52 patients were preoperatively with chronic diseases,and 28 patients suffered from postoperative complications.Conclusion The TNM of most elderly patients with gastric cancer were in stage Ⅲ and stage Ⅳ,and a large number of the patients had chronic diseases before operation.The method of the surgical treatment is determined by the patient’s condition.Perioperative management should be given emphasis to so that there will be more thorough removal and fewer complications.