全胃切除术与近端胃大部切除术治疗胃底贲门癌的远期疗效对比

目的 探讨不同术式治疗胃底贲门癌的远期疗效.方法 对58例胃底贲门癌患者采用手术治疗,其中全胃切除术29例,近端胃大部切除术29例.分析比较2组患者术后并发症和5年生存率.结果 全胃切除术和近端胃大部切除术患者3年生存率分别为62.07%和44.83%(P>0.05),5年生存率为48.28%和20.69%(P<0.05).近端大部切除组的反流性食管炎发生率为75.86%,高于全胃切除组的34.48%(P<0.05);2组患者的其他并发症发生率无统计学差异.肿瘤>3.0 cm和淋巴结转移患者全胃切除后5年生存率高于近端大部切除组(P<0.05),其他情况2组的生存率比较无差异.结论 对胃底贲门癌患者实施全胃切除术治疗能够有效提高患者的长期生存率,尤其是对于肿瘤>3.0 cm和出现淋巴结转移的患者.

Long-term Therapeutic Effects of Total Gastrectomy Versus Proximal Gastrectomy for Gastric Cardia Carcinoma

Objective To study the long-term efficacy of different operative methods for gastric cardia cancer .Methods 58 patients with gastric cardia carcinoma underwent radical resection .29 cases were treated with total gastrectomy (group TG),29 cases received proximal gastrectomy (group PG).5-year survival rates and the postoperative complication rate of the 2 groups were followed up and compared .Results 3-year survival rates of group TG and group PG were 62.07%and 44.83%respective-ly (P>0.05),5-year survival rates of group TG and group PG were 48.28%and 20.69%(P<0.05).The incidence of reflux esophagitis of group PG was 75.86%,higher than that of group TG,34.48% (P<0.05).Other complications of the 2 groups had no significant difference .5-year survival rate of patients with tumor was greater than 3.0 cm and lymphatic metastasis in group TG was higher than group PG (P<0.05).The 2 groups had no difference in survival rates .Conclusion Patients with gastric cardia cancer treated with total gastrectomy can effectively improve the long-term survival,especially for the patients with tumors larger than 3.0 cm and lymphatic metastasis .