远端胃癌新的规范化D_2手术的临床应用

Clinical application of the new criterion D_2 operation in distal gastric carcinoma

目的 验证远端胃癌新的规范化D2 手术可行性 ,通过新的D2 手术为TNM分期和术后综合治疗提供准确依据。方法 通过同期远端胃癌 5 3例行新的规范化D2 手术 (D2 组 )和 72例非规范化D2 手术 (非D2 组 )资料统计 ,对住院时间、手术时间、术中出血、术后并发症进行分析。结果 D2 组与非D2 组平均住院时间分别为 :(2 8.4± 37.9)d、(31.6± 2 8.1)d ;术中平均出血分别为 :(5 4 0 .2± 2 12 .2 )ml、(495 .6± 196 .7)ml,两组间均无显著性差异 (P >0 .0 5 ) ;平均手术时间分别为 :(2 36 .3± 72 .5 )min、(172 .4± 6 4 .5 )min ,D2 组手术时间明显延长 (P <0 .0 1) ;手术并发症分别为 :7例 (13.2 % )、9例 (12 .5 % ) ,两组间无明显差异 (P >0 .0 5 )。结论 新的规范化D2 手术和非D2 手术临床治疗时间和手术风险无明显差异 ,D2 手术能为临床TNM分期和术后综合治疗提供准确依据 ,值得推广。

Objective To testify the feasibility of the new cri terion D 2 operation in distal gastric carcinoma. Methods The clinical data of 125 patients who were diagnosed as distal gastric carcinoma were collected. The new criterion D 2 operation (D 2 team) was performed in 53 patients, and the rest received the non-D 2 operati on (non-D 2 team). The average hospital stay; operation time; bleeding volume; post-operation complication were analyzed. Results The average in-patient time of D 2 team and non-D 2 team respectively were: 28.4±37.9 days, 31.6±28.1 days; bleeding volume respe ctively were: 540.2±212.2 ml (D 2 team), 495.6±196.7 ml (non-D 2 team), no significant difference exits between the two teams (P>0.05). The mean operat ion time of D 2 team was significantly longer than that in non-D 2 team (236. 3±72.5 minutes vs 172.4±64.5 minutes, P<0.01). No significant differen ce was found in incidence of post-operation complication between the two teams [7 cases in D 2 team (13.2%) vs 9 cases in non-D 2 team (12.5%), P>0 .05]. Conclusions No significant clinical therapy and operation risk exits in the new criterion D 2 operation.