扩大联合脏器切除治疗T4b期胃癌的临床分析

目的探讨扩大联合脏器切除T4b期胃癌的疗效,总结手术经验。方法对2012年1月至2015年12月在哈尔滨医科大学附属第一医院手术治疗的128例T4b期胃癌临床资料进行回顾性分析。结果 85例行扩大联合脏器切除术(extended multi-organ resection,ER组),43例行姑息性手术(non-extended multi-organ resection,NER组)。随访ER组1年、2年、3年的生存率分别为65.38%、44.87%和38.46%,均高于NER组的35.13%、16.21%和5.41%,两者之间的差异均有统计学意义(P0.05)。ER组的并发症发生率为18.82%,高于NER组的4.65%,两组之间的差异有统计学意义(P0.05);ER组的围手术期病死率为2.35%,NER组为2.33%,两者之间的差异无统计学意义(P0.05)。结论扩大联合脏器切除是安全可行的,可以延长病人生存期,改善临床症状,提高生存质量。

Clinical analysis of extended multi-organ resection for T4b gastric cancer

Objective To investigate the efficacy and summarize the treatment experience of extended multi-organ resection for T4b gastric cancer.Methods The clinical data of 128 cases for T4b gastric cancer from January 2012 to December 2015 were analyzed retrospectively in our hospital.Results Eighty-five patients received extended multi-organ resection (ER group),and 43 patients palliative surgery (NER group).During the follow-up period,one-,2-and 3-year survival rate in ER group was significantly higher than in NER group (P＜0.05).The incidence of postoperative complications in ER group was significantly higher than in NER group (P＜0.05).The perioperative mortality in ER group was slightly higher than in NER group (P＞0.05).Conclusions The extended multi-organ resection is safe and feasible,and can prolong the survival and improve clinical symptoms and quality of life.