全胃切除治疗胃癌的预后观察

本文分析了我院1973年10月～1986年8月施行全胃切除的73例胃癌患者的临床资料、手术、病理检查及手术并发症等。术后近期死亡5例,手术病死率6.8%。随访58例(86%),术后1、3、5年的生存率分别为50%、34%和22%。半数以上患者术后有不同程度的碱性反流性食管炎症状。指出患者的年龄大小、病期长短及组织类型对预后的影响不大,但癌肿的浸润程度尤其是胃壁浆膜层的浸润、淋巴结的转移范围、全胃切除同时采用不适当的联合脏器切除、术后吻合口瘘(10.8%)、感染等并发症及营养不良、恶液质等是影响预后的主要因素。

Prognostic Observation of the Total Gastrectomy for Gastric Cancer

From October 1973 to August 1986, 73 patients of the gastric cancer were treated with total gastrectomy. The clinical material, operative technic, pathologic study and postoperative complications were analysed. Five of 73 cases (6.8%) died within one month of surgery. Followup rate was 86% and survival rates of 1, 3 and 5 years were 50%, 34% and 22% respectively. About half of the patients complained of symptoms of reflux esphagitis. The affecting prognostic factors such as age, course of the disease and pathalogic findings seem irreverent. However, the degree of infiltration (particulaly the infiltration of gastric serosa), lymphatic metastases, leaking of gastric anastomotic live, and nutritional disturbance are main affecting prognostic factors.