进展期近端胃癌86例不同术式选择及其预后分析

目的:探讨进展期近端胃癌采用全胃切除及近端胃切除两种手术方式对患者预后的影响。方法:选择86例进展期胃癌患者,A组(n=35)采用全胃切除术,B组(n=51)采用近端胃切除术,记录手术时间、术中出血量、术后并发症及生存率并做统计学分析。结果:A、B两组在术中情况比较差异无统计学意义(P>0.05);A组术后并发症发生率明显低于B组(P<0.05);A、B两组术后1年生存率分别为85.71%、80.39%,2年生存率分别为71.43%、60.78%,5年生存率分别为40%、25.49%,差异均具有统计学意义(P<0.01)。结论:对进展期胃癌的术式选择,全胃切除加D2淋巴结清扫能降低术后并发症,改善患者生活质量,提高术后生存率。

Different Surgical Options and Prognosis of 86 Patients with Advanced Proximal Gastric Cancer

Objective：To investigate the use of total gastrectomy and proximal gastrectomy two surgical methods on patients with advanced proximal gastric cancer.Methods：86 cases of advanced gastric cancer,A group was treated by total gastrectomy（n=35）,B group was treated by proximal gastric resection（n=51）.Recording operation time,blood loss,postoperative complications,survival.Results：There was no significant difference during the intraoperative（P0.05）.The complication rate of A group was significantly lower than B group（P0.05）.The one year,two year and five year survival rates of A,B groups were 85.71%,80.39%,71.43%,60.78%,40%,25.49% respectively.The differences were statistically significant（P0.01）.Conclusion：It was more appropriate to adopt total gastrectomy for patients with advanced proximal gastric cancer.It can reduce complications,improve patient quality of life and the survival rate.