新辅助化疗对进展期胃癌患者术后肺部感染的影响

目的探讨新辅助化疗对进展期胃癌患者术后肺部感染的影响。方法按随机数字表法将2009年1月至2011年1月间在南京军区南京总医院接受治疗的139例伴有淋巴结转移的胃癌病例（排除术前重度肺功能障碍者）,随机分为新辅助化疗组69例,动静脉结合新辅助化疗（静脉用药：氟尿嘧啶、亚叶酸：动脉介入：奥沙利铂、表阿霉素、依托泊甙）1个半疗程后接受手术]和直接手术组（70例）,比较两组病例术后肺部感染的发生情况。结果两组病例术前一般情况的比较差异无统计学意义（均P〉0．05）。所有病例均顺利实施D2胃癌根治手术,术后新辅助化疗组和直接手术组分别有8例（11．6％）和9例（12．9％）患者出现肺部感染,差异无统计学意义（P〉0.05）。结论动静脉结合新辅助化疗不会增加胃癌患者术后肺部感染发生率,可安全应用。

Effect of neoadjuvant chemotherapy on the postoperative pulmonary infection of patients with advanced gastric cancer

Objective To evaluate the effect of neoadjuvant chemotherapy on the postoperative pulmonary infection of patient with gastric cancer. Methods Between January 2009 and January 2011, 139 patients with curable stage T2N2 or T3N2 gastric cancer were randomly assigned to group 1 (69 cases, neoadjuvant chemotherapy with combined preoperative intraarterial infusion and intravenous chemotherapy before gastrectomy and D2 lymphadenectomy) and group 2 (70 cases, gastrectomy and D2 lymphadenectomy alone). The morbidity of postoperative pneumonia in the two groups were recorded respectively. Results The two groups were similar with respect to various clinical or pathological characteristics. All the patients underwent gastrectomy and D2 lymphadenectomy successfully. Eight patients in group 1 suffered from the postoperative pneumonia, accounting for 11.6%. Nine patients in group 2 suffered from the postoperative pneumonia, accounting for 12.9%. There was no significant difference between the two groups about the incidence of postoperative pneumonia. Conclusion Surgery following neoadjuvant chemotherapy with combined preoperative intraarterial infusion and intravenous chemotherapy is safe with similar morbidity of postoperative pneumonia to immediate surgery in patients with locally-advanced resectable gastric carcinoma.