老年胃癌手术治疗分析

Analysis of the Surgical Treatment Effect of 83 Elderly Patients with Gastric Carcinoma

目的:探讨老年胃癌围手术期处理的有关问题及适当的手术方式。方法:回顾性分析2004-09-2009-01收治的83例65岁以上老年胃癌患者临床资料。结果:83例中76例行胃癌切除术,切除率为91.6%。其中行根治性切除术57例(68.7%),姑息性切除19例(22.9%),仅行胃空肠吻合术4例(4.8%),仅行探查取活检者3例(3.6%)。55例(66.3%)术前并存其他疾病。手术前有并存疾病者,术后并发症的发生率为43.6%(24/55),显著高于术前无并存疾病者的术后并发症的发生率(14.3%,4/28,P<0.01)。结论:老年胃癌手术方式应根据病情而定,对早期或中期胃癌力争行D2根治性手术。加强围手术期处理,可提高手术的安全性,减少并发症的发生。

Objective：To investigate the characteristics of the perioperative management and the reasonable surgical measures for the elderly patients with gastric carcinoma.Methods：The clinical data of 83 elderly patients with gastric carcinoma over 65 years old from September 2004 to January 2009 were analyzed retrospectively.Results：76 cases with gastrectomy,the rate was 91.6%.57 cases（68.7%）were subjected to radical gastrectomy,19 cases（22.9%）were subjected to palliative gastrectomy,4 cases（4.8%）were subjected to gastrojejunostomy and 3 cases（3.6%）were subjected to biopsy.55 cases（66.3%）with preoperative complications,the incidence of postoperative complications was 43.6%（24/55）,which is significantly higher than that in the patients without preoperative complications（14.3%,4/28,P〈0.01）.Conclusions：The surgical treatment methods for the elderly patients with gastric carcinoma should be determined according to the pathogenetic conditions.The radical gastrectomy and lymphadenectomy（D2）should be done as soon as possible for the early and middle stage gastric cancer.Strengthening the perioperative management could improve the security of the operation and decrease the postoperative complications.