胃小弯全切术与传统根治术治疗远端胃癌的效果对比分析

Comparative Analysis on the Effect of Total Resection of Lesser Curvature and Conventional Radical Resection in the Treatment of Distal Gastric Cancer

目的与传统根治术相对比,分析胃小弯全切术治疗远端胃癌的疗效。方法将2008年至2009年10月本院收诊的远端胃癌患者随机分成两组:对照组和观察组,各120例。对照组采用传统根治术治疗,观察组则进行胃小弯全切术,术后对所有患者进行化疗。对所有患者进行跟踪随访,比较两组间淋巴结清除情况差异;统计两组间1、2、3年生存率及复发率差异;统计两组间并发症发生率差异。结果观察组淋巴结清除数和平均每例清除数显著大于对照组,P<0.05。观察组术后1、2、3年生存率分别为81.67%、70%和60.83%,显著高于对照组的72.50%、62.50%和54.17%;观察组复发率为19.17%,显著低于对照组的30.83%(P<0.05)。观察组营养吸收障碍的发生率和总并发症发生率显著低于对照组,P<0.05。结论胃小弯全切术治疗远端胃癌淋巴清除效果好,生存率高,复发率和并发症发生率低,效果优于传统根治术。

Objective To analyze the efficacy of total resection of lesser curvature in the treatment of distal gastric cancer and to compare with conventional radical mastectomy. Methods The patients with distal gastric cancer from 2008 to October 2009 were randomly divided into two groups： the control group and the observation group, with 120 cases in each group. The control group was taken with conventional radical resection, while the observation group was taken with total resection of lesser curvature; and all patients received postoperative chemotherapy. Patients were followed up to compare the difference between the two groups in lymphadenectomy situation. The statistical year survival rates between the two groups and the difference in relapse rate and complication incidence were taken for statistical analysis. Results The number of removed lymph nodes and the average number of per case clearance in the observation group was significantly lager than that in the control group （P 〈0.05）. The 1, 2 and 3 years survival rates after surgery were 81.67%, 70% and 60.83% in the observation group, significantly higher than those of 72.50%, 62.50% and 54.17% in the control group. The recurrence rate in the observation group was 19.17%, which was significantly lower than 30.83% of the control group （P 〈0.05）. The incidence of malabsorption of nutrients and overall complication rate in the observation group was significantly lower than that in the control group （P 〈0.05）. Conclusions Total resection of lesser curvature is effective in the treatment of distal gastric lymph node dissection; it has the advantages of high survival rate, low recurrence rate and complication rate, and its effect is better than the traditional radical resection.