经腹全胃切除治疗进展期胃癌25例疗效观察

目的 总结经腹全胃切除治疗进展期胃癌的经验。方法 回顾性分析1998年6月－2001年7月，对25例进展期胃癌病人行全胃切队的临床资料。所有病人均经腹部手术，用吻合器行标准的端侧食管空肠Roux-en-Y吻合。结果 根治性全胃切除20例，姑息性全胃切除5例。其中联合脾切除1例。7例出现并发症，其中4例为肺部感染，无吻合口瘘和吻合口狭窄。除手术死亡1例（4％）外，24例均获得随访，术后病人能顺利进食，未出现返流性食管炎症状。1年,2御和3年生存率分别为74％，45％和38％。结论 全胃切除治疗进展期胃癌能提高患者的生活质量和延长生存期。选择合理的消化道重建方式，加强围手术期处理是减少手术并发症的重要因素。

TREATMENT OF 25 CASES OF ADVANCED GASTRIC CARCINOMATHROUGH ABDOMINAL TOTAL GASTRECTOMY

Objective To summarize the experience of abdominal total gastrectomy for advanced gastric carcinoma.Methods The clinical data of 25 cases of advanced gastric carcinoma treated with abdominal total gastrectomy from June 1998 to July 2001 were analyzed retrospectively.All patients underwent a standard end to side Roux en y esophagojejunostomy with an anastomat.Results Radical total gastrectomy was performed for 20 cases,Palliative total gastrectomy for 5 cases and only 1 got combined splenectomy.7 patients suffered from postoperative complications,the most common of which was pneumonia (n=4).No anastomic leakage and anastomic stricture occurred.Only one case (4%) died in operation.The follow up surveys of 24 cases showed that patients could take in food postoperatively and no reflux esophagitis occurred.The survival rates of them in the first,second and third years were 74%,45% and 38% respectively.Conclusion Total gastrectomy is an effective operation for advanced gastric carcinoma.It can improve patients' quality of life and prolong their survival periods.Rational reconstruction of patient's digestive tract and intensive perioperative care will decrease postoperative complications.