胃上部癌行全胃切除与近端胃切除的疗效对比

目的研究讨论胃上部癌行全胃切除与近端胃切除的临床疗效对比与意义。方法选取本院外科胃上部癌患者100例,其中50例采用全胃切除术治疗,50例采用近端胃切除术治疗,分别对两组患者治疗后并发症发生情况、手术后生存率以及术后恢复情况进行评估。结果两组患者治疗后并发症发生率比较显示行全胃切除术患者并发症发生率显著低于近端胃切除术患者（P〈0.05）;治疗后癌灶大小与患者生存率比较显示癌灶〉3 cm与〈3 cm治疗后1年生存率无较大差异（P〉0.05）;治疗后3～5年全胃切除术生存率显著较高（P〈0.05）。恢复情况比较显示治疗后近端胃切除术患者各项恢复指标优于全胃切除术组患者（P〈0.05）。结论胃上部癌要根据肿瘤的大小,分期,采取合理的手术方式,全胃切除术可降低术后相关并发症,改善生活质量,提高生存率,临床疗效更为确切。

Comparison on clinical effects of total gastrectomy and proximal gastrectomy for treatment of upper stomach cancer

Objective To study and discuss the comparison and significance between clinical effects of total gastrectomy and proximal gastrectomy for treatment of upper stomach cancer. Methods 100 patients with upper stomach cancer were chosen and divided randomly into A group and B group. 50 patients of A group were given total gastrectomy while B group was given proximal gastrectomy. Complications, survival rates and recovery conditions after operations of the 2 groups were evaluated. Results Occurrence rate of complications of B group was obviously lower than A group（P〈0.05）. No significant differences existed between survival rates 1 year after treatments of the 2 groups（P〉0.05）; survival rates 3 and 5 years after treatments of A group were obviously higher than B group（P〈0.05）. Recovery indicators after treatment of B group were all superior to A group（P〈0.05）. Conclusion Total gastrectomy and proximal gastrectomy both have significant clinical effects for treatment of upper stomach cancer. Total gastrectomy can remove lesions completely and avoid recurrence of lesions. Proximal gastrectomy has few postoperative complications, high safety and high survival rate. Patient＇s condition should be evaluated detailedly before chose and implement of surgical method.