全胃切除治疗老年胃癌的临床分析

Clinical analysis on senile cases of gastric carcinoma treated with total gastrectomy

目的探讨全胃切除治疗老年胃癌的临床经验。方法回顾性分析我院2004年1月～2010年12月间行全胃切除术治疗老年胃癌病人58例临床资料,对老年胃癌特征点、术后并发症的发生率、围手术期处理等进行总结和分析。结果老年胃癌以分化型腺癌为主,病理分期以中晚期为主。术前营养状况差,合并症多。全胃切除术的术后并发症发生率为29.3%(17/58),死亡率为3.45%(2/58),其中吻合口瘘的发生率为1.72%(1/58)。结论全胃切除术治疗老年胃癌是安全的。降低手术死亡率和并发症发生率的关键在于个体化的围手术期的处理。减小手术创伤、缩短手术时间、加强营养支持,提高患者对手术的耐受性。

Objective To analyze the effect of total gastrectomy for gastric cancer in gerontal patients.Methods A total of 58 gerontal patients with gastric carcinoma treated with total gastrectomy from Jan 2004 to Dec 2010 were analyzed retrospectively.The characteristic of gastric cancer in gerontal patients,the incidence of postoperative complication and the handling in peroperative period were investigated.Results Differentiated adenocarcinoma and advanced gastric carcinoma were the common category in most senile patients.The preoperative nutritional status was poor and the dominant diseases were serious in most gerontal patients.The incidence of postoperative complications was 29.3%（17/58） and the mortality was 3.45%（2/58）.The incidence of anastomotic leakage was 1.72%（1/58）.Conclusions Total gastrectomy is a safe treatment for the elderly patients with gastric cancer.The individualized treatment is the key to cut down the mortality and complications.Decreasing surgical trauma,shortening operation time and strengthening nutritional support can elevate the survivability of gerontal patients.