侵犯浆膜层胃癌D2术式与D3术式的临床对照研究

Controlled clinical study on the D2 operation and D3 operation in gastric cancer invaded the subserosal layer

目的比较侵犯浆膜层胃癌D2术式与D3术式的临床疗效。方法选取2006年1月至2007年11月于本院采用D2术式进行治疗的48例侵犯浆膜层的胃癌患者为A组,同期采用D3术式进行治疗的48例患者为B组,然后将两组患者的并发症发生率、2年、3年、5年的生存率及手术前、手术后不同时间段的Spitzer量表评分、血清肿瘤标志物进行比较。结果 B组的2年、3年、5年的生存率高于A组,而手术后3个月、6个月及12个月的Spitzer量表评分均高于A组,血清肿瘤标志物水平均低于A组,其差异均具有统计学意义(P均<0.05),但两组患者的并发症发生率差异无统计学意义(P>0.05)。结论 D3术式在侵犯浆膜层胃癌中的综合优势大于D2术式,对患者的生存质量发挥着积极的作用。

Objective To compare the clinical effect of D2 operation and D3 operation in gastric cancer in- vaded the subserosal layer. Methods Forty-eight patients with gastric cancer invaded the subserosal layer who were treated with D2 operation in our hospital from January 2006 to November 2007 were selected as group A, and 48 pa- tients who were treated with D3 operation at the same time were selected as group B. Then the incidence of complica- tions, 2-year, 3-year, and 5-year survival rate, Spitzer score and serum tumor markers before and after the operation at different time points were compared between the two groups. Results The 2-year, 3-year, and 5-year survival rate of group B were significantly higher than those of group A （P〈0.05）. Spitzer scores 3, 6 and 12 months after the opera- don were all significantly higher than those of group A （P〈0.05）, and levels of serum tumor markers were all significantly lower than those Of group A （P〈0.05）. The incidence complications showed no statistically significant difference between the two groups （P〉0.05）. Conclusion The comprehensive advantages of D3 operation in gastric cancer invaded the subse- rosal layer are better than that of D2 operation, and it plays an active role for the life quality of patients.