胃癌D1和D2术式的疗效比较

目的 评价进展期胃癌D1和D2术式的疗效。方法 前瞻性收集1996年6月至2000年5月60例可切除性远侧胃癌，将患者随机分为D1组30例和D2组30例，分别由两组年资相当的医生进行手术操作。结果 两组患者无手术死亡。经统计，术后转移复发率1年D1组40．0％、D2组3．3％；2年D1组53．3％、D2组10．0％；3年D1组56．6％、D2组13．3％、4年D1组60．0％、D2组16．7％。提示D2与D1比较差异有极显著性意义（P＜0．01）；术后生存率1年D1组73．3％、D2组96．7％；2年D1组59．3％、D2组96．5％；3年D1组53．6％、D2组83．3％；4年D1组44．5％、D2组80．0％（P＜0．05）。结论 D2术式在减少胃癌术后转移复发率及提高生存率方面，效果明显优于D1术式，可作为进展期胃癌的首选手术。

COMPARISON OF THETHERAPEUTIC EFFECTS OF D1 TO D2 OPERATIVE METHODS IN GASTRIC CANCER

Objective　To evaluate the therapeutic effects of D1 and D2 operative methods for advanced gastric carcinoma. Methods　 60 cases of the resectably distal gastric cancer were colleted prospectively and they were randomly divided into group D1 (30 cases) and group D2 (30 cases). They were operated respectively by the doctors with equivalent grade in two groups. Results　No patients in the two groups died from the operation. The rate of recurrence and metastasis in group D1 and D2 was 40.0% and 3.3% (P＜0.01) respectively in a year, 53.3% and 10.0%(P＜0.01) in two years, 56.6% and 13.3% (P＜0.01) in three years, 60.0% and 16.7% (P＜0.01) in four years； The survival rates in group D1 and D2 were 73.3% and 96.7%(P＜0.05) in a year, 59.3% and 96.5% (P＜0.01) in two years, 53.6% and 83.3% (P＜0.05) in three years, 44.4% and 80.0% (P＞0.05) in four years, respectively. Conclusion　In reducing the recurrent rate of gastric cancer and increasing the postopertive survival rate, the D2 operative method is much better than the D1 operative method, and it can be the first choice for advanced gastric carcinoma.