全胃切除治疗进展期胃癌84例分析

Analysis of 84 Total Gastrectomy Patients with Advanced Gastric Cancer

目的 探讨全胃切除指征、手术切除范围及全胃切除术后消化道重建方式对生存质量的影响。方法 回顾性分析 84例全胃切除临床资料。结果 男性 5 5例 ,女性 2 9例。年龄 2 7～ 73岁。根治性全胃切除 73例 ,姑息性切除 11例。全组术后并发症 2 2例( 2 6 19% ) ,手术死亡 2例 ( 2 3 8% )。术后 1、3、5年生存率分别为 90 48% ( 76/ 84)、45 3 3 % ( 3 4 / 75 )、2 7 5 9% ( 16/ 5 8)。结论 :全胃切除术是治疗胃癌的一种重要、有效的术式 ,应根据患者的年龄、营养状况、病期合理掌握适应证及手术切除范围 ,消化道重建方式与术后并发症和术后生存质量有关 ,“P”型空肠代胃术后生存质量较好。术后辅助治疗可提高远期生存率。

Objective To approaeh the indicators of total gastrectomy,the removal range and the effect of modulity of reestablishing peptic tract after total gastrectomy on servival quality.Methods Retrospectively analysing clinical data of 84 total gastrectomy cases.Results In 84 cases there are 55 males and 29 females aging from 27 to 73.9 adical total gastrectomy was performed for 73 patients,palliative total gastrectomy was performed for 11 patients.22 patients had postoperative complications(26.19%),operative mortality rate is 2.38%(2 cases died).The survival rate in 1,3 and 5 years after operation are 90.48%(76/84),45.33%(34/75),27.59%(16/58),respectively.Conclusions The total gastrectomy is an important and effective operative modulity for treating gastric cancer.The operative indicators and removal range are based on patient′s age and nutrient condition.The modulity of re-establishing Peptic tract is associated with the postoperative complications and survival quality.The postoperative accessory treatment will increase the postoperative long-team servival rate.