胃上部癌行胃近端大部切除与全胃切除术后患者生活质量比较

Comparison of the quality of life after proximal and total gastrectomy on proximal gastric cancer

目的:比较胃上部癌行胃近端大部切除术和全胃切除空肠间置代胃术患者手术效果对术后生活质量的影响。方法:胃上部癌患者86例,随机数字法分胃近端大部切除术组43例和全胃切除空肠间置代胃术组43例,由同一外科医生进行手术,对术后并发症的发生率、病死率、生存率、体质量指数、生活质量进行5年随访,生活质量评价采用Spitzer指数分析。结果:胃近端大部切除术组和全胃切除空肠间置代胃术组术后发生并发症患者分别为19例和24例,病死率分别为2%(1/43)和5%(2/43),5年生存率分别为53%(23/43),65%(28/43),均无显著性差异。随访5年后,胃近端大部切除组23例,空肠间置代胃组28例没有出现癌复发,两组在体质量指数和Spitzer指数上均无显著性差异。结论:胃上部癌患者行全胃切除空肠间置代胃术与行近端胃大部切除术术后生活质量无明显差异。

AIM:To compare the effects of total gastrectomy(jejunal interposition,JI) and proximal gastrectomy(PG)on the quality of life(QOL) in patients with proximal gastric carcinoma. METHODS:Eighty six patients with proximal gastric carcinoma were divided into PG group(n=43) and JI group(n=43) by means of random number table.After all the patients were operated by the same surgeon,the incidence of complications,mortality,survival rate,body mass index(BMI) and QOL were followed up for five years.The QOL was assessed with the Spitzer index analysis. RESULTS:There were 19 and 24 cases of complications in the two groups respectively,mortality[2%(1/43) and 5%(2/43), respectively] and the five year survival rate[53%(23/43) and 65 %(28/43) respectively].For long term functional comparison,23 patients in the PG group and 28 in the JI group were not found recurrence after 5 year follow up.Comparison of the BMI and the Spitzer index between the two groups were no any significant differences. CONCLUSION:For the patients with proximal gastric carcinoma,total gastrectomy(JI) and proximal gastrectomy are no significant differences in improving their QOL.