236例老年胃癌患者的外科诊治与分析

目的探讨老年人胃癌的临床病理特征及外科手术治疗。方法 236例患者均接受手术治疗,其中行胃部分或全部切除术215例,未能切除21例。术前并存慢性疾病89例(37.7%)。结果术后出现并发症80例,死亡4例。术后pTNM分期:Ⅰa期39例(16.5%),Ⅰb期27例(11.4%),Ⅱ期41例(17.4%),Ⅲa期47例(19.9%),Ⅲb期31例(13.1%),Ⅳ51例(21.6%)。5年生存率Ⅰa期、Ⅰb期、Ⅱ期、Ⅲa期、Ⅲb期、Ⅳ期分别为90.5%、89.3%、62.3%、30.6%、19.4%和1.9%。结论老年胃癌患者病理分期多为Ⅲa期、Ⅳ期,术前多伴有慢性疾病,手术是首选治疗方法,但要注意围术期处理。

Analysis of surgical treatment in 236 cases of elderly gastric cancer

Objective To explore the pathological manifestations and surgical treatment for elderly gastric cancer.Methods 236 patients received surgical treatment,including 28 cases of gastric resection and 21 cases of celiotomy only.89 patients（37.7%） had coexistent chronic diseases.Results 80 patients had postoperative complications,4 patients died after operation.The pTNM stage were Ⅰa in 39 cases（16.5%）,Ⅰb in 27 cases（11.4%）,Ⅱ in 41 cases（17.4%）,Ⅲa in 47cases（19.9%）,Ⅲb in 31cases（13.1%） and Ⅳ in 51cases（21.6%）.The 5-year survival rates ofⅠa,Ⅰb,Ⅱ,Ⅲa,Ⅲb and Ⅳ were 90.5%,89.3%,62.3%,30.6%,19.4% and 1.9% respectively.Conclusion The majority of elderly patients with gastric cancer belong to stage Ⅲa,Ⅳ.They frequently have chronic diseases.The surgical treatment is the first choice to patients.But,the perioperative management should be strengthened.