经腹或胸两种途径全胃切除术根治老年贲门癌患者的疗效比较

目的 观察并探讨经腹根治性全胃切除术治疗对老年贲门癌患者的临床疗效。方法分析在我院接受治疗的老年贲门癌患者56例,根据治疗手术方式的不同将患者分为经腹全胃切除组(腹治组)和经胸全胃切除组(胸治组)。记录和比较两组患者的手术时间、术中出血量、术后引流量、住院时间、治疗后的并发症情况、SF-36生活质量评分以及不同时间段的生存率,并进行统计分析。结果腹治组的手术时间、术中出血量、术后引流量以及住院时间明显低于胸治组组(P＜0.05)；腹治组和胸治组的并发症总发生率分别为16.0%(4/25)和58.1%(18/31),尤以腹治组和胸治组的肺部感染发生比例分别为4.0%(1/25)和25.8%(8/31)(P＜0.05)；腹治组的SF-36评分明显优于胸治组(P＜0.05)；两组患者术后术后1年和3年的生存率无明显差异(P＞0.05)。结论通过经腹根治性全胃切术治疗老年贲门癌患者,具有创伤小、并发症少、明显改善生活质量等优点,表现出更好的疗效,在临床上值得推广应用。

Comparison of the Efficacy of Transabdominal and Transthoracic Radical Total Gastrectomy for Elderly Patients with Cardiac Carcinoma

Objective To evaluate the efficacy of transabdominal radical total gastrectomy for elderly patients with cardiac carcinoma.Methods56 patients with cardiac carcinoma in the hospital were selected.According to the different methods of treatment,patients were divided into transabdominal radical total gastrectomy group (TARG) and conventional transthoracic radical total gastrectomy group(TTRG).The operation time,intra-operative blood loss,postoperative drainage,hospital stay,posttreatment complications occuring,SF-36 score and survival rate of different period in two groups were recorded.ResultsThe operation time,intra-operative blood loss,postoperative drainage,hospital stay in the TARG were obviously lower than these in the TTRG group (P<0.05);the rates of postoperative complication in the TARG and the TTRG were respectively 16.0% (4/25) and 58.1% (18/31),and the rates of pulmonary infection occurring in the TARG and the TTRG were respectively 4.0% (1/25) and 25.8% (8/31) (P<0.05);the SF-36 score in the TARG were obviously higher than these in the TARG (P<0.05);the survival rates of 1 year and 3 year after the treatment in the two groups have no obvious difference.ConclusionTransabdominal radical total gastrectomy has a better curative effect with fewer complications,improves quality of life for patients with cardiac carcinoma,and is worth popularization and application in clinic.