胃裸区淋巴结清扫对胃癌患者预后的影响

摘要：目的  探讨胃裸区淋巴结清扫对胃癌患者术后生活质量（QOL）的影响。方法  选取185例近端胃癌患者的手术及随访资料，依据术中是否行胃裸区淋巴结清扫分为两组：观察组95例，行胃癌D2根治联合胃裸区淋巴结清扫；对照组90例，行常规胃癌D2根治术。观察两组胃裸区淋巴结阳性率、围手术期并发症、不良反应发生率及QOL等。结果  胃祼区淋巴结阳性率高达66.3%。观察组局部复发率低于对照组，5年生存率高于对照组。两组患者术后QOL均改善，观察组优于对照组（P <0.05）。观察组在12、24和36个月的QOL总分高于对照组（P <0.05）。结论  近端胃癌根治术中常规行胃裸区淋巴结清扫可明显改善患者术后QOL。

Effect of gastric bare area lymphadenectomy on quality of life in patients with gastric cancer

 Abstract: Objective To explore the quality of life in patients with gastric cancer who received stomach bare area lymphadenectomy. Methods The surgical and follow-up data of 185 cases, who had proximal radical gastrectomy for gastric cancer, were collected. The patients were divided into two groups according to whether the lymph nodes in gastric bare area were removed. Group A included 95 cases who received D2 gastrectomy combined with stomach bare area lymphadenectomy. Group B included 90 cases who underwent routine D2 lymphadenectomy. The positive rate of lymph nodes in the stomach bare area, perioperative complications, incidences of adverse reactions, local recurrence rate, 5-year survival rate, and Spitzer score were recorded in different periods. Results The positive rate of lymph node of stomach bare area was as high as 66.3%. The local recurrence rate of the group A was significantly lower than that of the group B, while the 5-year survival rate was significantly higher than that of the group B. The postoperative quality of life was significantly improved in both groups, which was significantly better in the group A (P < 0.05). The total scores of the quality of life in the group A were significantly higher than those in the group B 12, 24 and 36 months after operation (P < 0.05). Conclusions Proximal radical gastrectomy with routine dissection of lymph nodes in stomach bare area can significantly improve the postoperative quality of life in patients with gastric cancer.