进展期胃癌D2与D3术式的近、远期疗效比较

Comparison on the long-term and short-term effects of D2 operation and D3 operation for patients with advanced gastric carcinoma

目的比较进展期胃癌D2与D3术式的近期及远期疗效。方法选取2006年1月～2007年12月于韶关市粤北人民医院进行治疗的104例患者为研究对象，根据其手术方式的不同分为A组（D2术式）52例和B组（D3术式）52例，比较两组患者术中出血量、手术时间、胃肠道功能恢复时间、手术前后的QOL评分及术后1、2、3、5年生存率、复发率。结果B组术中出血量大于A组，手术时间长于A组，但术后6周的QOL评分指标优于A组，且术后1、2、3、5年生存率高于A组，复发率低于A组，差异均有统计学意义（均P〈0．05），而两组术后2周的QOL评分及胃肠道功能恢复时间差异无统计学意义（均P〉0．05）。结论D3术式对患者的手术性不良影响大于D2术式，但是其术后恢复较快，而远期疗效优于D2术式。

Objective To compare the long-term and short-term effects of D2 operation and D3 operation for patients with advanced gastric carcinoma. Methods 104 patients with advanced gastric carcinoma in Yuebei People＇s Hospital of Shaoguan City from January 2006 to December 2007 were selected as research objects, and they were divided into group A （D2 operation） with 52 cases and group B （D3 operation） with 52 cases according tO the operation types Then the blood loss during the operation, operation time, recovery time of gastrointestinal function. QOL scores before and after operation and 1-year, 2-year, 3-years, 5-year survival rates and recurrence rates of the two groups were compared. Results The blood loss of group B during the operation was more than that of group A： operation time was longer than that of group A, but QOL score at 6 weeks after operation：,were better than that of group A： 1-year. 2- year, 3-years, 5-year survival rates were higher than those of group A. the recurrence rates were lower than those of group A, the differences were all statistically significant （all P 〈 0：05）. While the recorery time of gastrointestinal function and QOL score of the two groups had no significant differenceS at 2 weeks after operation （all P 〉 0.05）. Conclusion The operative bad influence of D3 operation for the patients is bigger than that of D2 operation, bu! its postoperative recovery is faster, and its long-term effect.is better than that of D2 operation.