经腹全胃切除术治疗胃恶性肿瘤

Transabdominal total gastrectomy for gastric malignancy

目的总结经腹全胃切除联合或未联合多脏器一期切除治疗胃恶性肿瘤４６２例手术的经验。方法分析１９７３～１９９７年４６２例各种类型贲门癌、胃底癌、胃体癌以及残胃癌行全胃切除术的临床资料，其中１１３例同时施行全胃切除及联合多脏器一期切除术。结果术后随访３８６例，随访率为８４％。随访时间为６～６０月，平均３４６月。全组１，３，５年生存率分别为３５３％，４６３％，１８４％。其中单纯全胃切除者分别为３３１％，４２３％，２４６％；联合多脏器切除者分别为３４６％，４０７％，２４７％。结论各类型胃癌行手术切除仍是目前最佳的治疗方法，对提高病人生存期。

Objective To summarize the experlience of 462 cases of gastric malignancies treated by transabdominal total gastrectomy with or without combined resection of invated organs. Methods The clinical data of 462 patients with cardiac or gastric carcinomata treated by total gastrectomy from 1973 to 1997 were analysed retrospeclively. Of them, 113 cases underwent combined resection of invated organs during the total gastrectomy. Results 386 patients(84%) have floowed up for 6～60 months (mean 34.6 months). In these patients, the postoperative survival rate of 1 , 3 , 5 year was 35.3%,46.3% and 18.4% respectively; and 1 , 3 , 5 year survival rate of total gastrectomy with or withou combined group resection of invated organs was 33.1%, 42.3%, 24.6% and 34.6%, 40.7%, 24.7%, respectively. Conclusions Surgical resection of gastric carcinomata is still the best choice of treatment for prolongable patient's survival time and releasing their discomfort.