胃癌的外科治疗分析

The Analysis of the Surgical Treatment to Gastric Cancer

目的:探讨胃癌外科治疗的现状。方法:对我院2003年5月～2008年5月收治并手术治疗的胃癌440例的临床资料进行回顾性分析。结果:440例胃癌中,手术切除404例(91.82%),其中根治性切除364例,姑息性切除40例;远侧胃切除312例(77.23%),近侧胃切除28例(6.93%),全胃切除64例(15.84%);行消化道重建的416例中,手法吻合40例(9.62%),双吻合器吻合376例(90.38%)。术后病理早期癌36例(8.18%),进展期胃癌共404例(91.82%)。术前肠外营养支持5～7天56例(12.73%),术后行肠内营养344例(85.15%),肠外营养360例(89.11%)。手术死亡1例(0.23%),40例发生术后近期并发症(9.09%)。结论:胃癌患者早期诊断仍困难,但手术切除率及根治性切除率较以前明显升高,吻合器使用明显增加,有助于降低近期并发症发生率并提高肿瘤治疗的效果。需长期营养支持时肠内营养较肠外营养更容易维持内环境稳定。

Objective:To analyze the surgical treatment of gastric cancer.Methods:Clinical data of 440 patients with gastric cancer from May,2003 to May,2008 were analyzed retrospectively.Results:Four hundreds and four of 440 patients(91.82%)underwent resection,including 364 radical operation and 40 palliative operation.A total of 312 underwent distal gastrectomy(77.23%),28 proximal gastrectomy(6.93%)and 64 total gastrectomy(15.84%).Among 416 cases of alimentary tract reconstructive operation,40 were anastomosed by man...