98例胃近端肿瘤临床分析

Clinical analysis of 98 patients with gastric proximal cancer

目的 探讨胃 近端肿瘤手术治疗措施与生存期的关系。方法 手术治疗８４例，按 胃近端肿瘤的大小、距贲门的距离、患者全身情况选择手术径路与术式，其中全胃切除３１例 ，上半胃切除４２例，下半胃切除１１例。经腹切口７２例，经胸腹联合切口８例，经胸切口４例。 术后常规ＦＭ方案化疗。与１４例仅化疗未行手术治疗者比较。结果 ８ ４例胃癌根治术者无手术死亡。随访１、３、５年，手术组８４例存活分别为８４、４４、２６例，５年 生存率为３０．９％。１４例未行手术者均在３～１１月内死亡。结论 胃近 端肿瘤手术切除可延长患者生存期，以肿瘤早期手术效果为佳。

Objective To study the relation between th e administration of surgical operation for the stomach proximal tumor and the sa rvival time.Methods The operation pathes and ways were cho se according to the tumor＇s size, distance to the cardia and the general sitacet ion of the patients. The patients effected a radical cure were 84, among which , total stomach excision 31 cases , upper half stomach excision 42 cases , lower half stomach excision 11 cases; by abdomen incision 72 cases , by chest abdomen combination incision 8 cases, by chest incision 4 cases. These patients receiv ed routine FM chemotherapise after operation and were compared with 14 patients received only chemotherapies or failed to excision.Results 84 patients with stomach tumor effected a radical cure didn＇t occure death rel ation to operation . After 1,3,5 years following visit , the survival ratio o f 84 patients received surgical operation was 84,44 and 26 cases respectively, the 5 years survival ratio was 30.9%. 14 patients who did not recieve surgical o peration or failed to excision died within 3-11 months exclusively.Con clusions The stomach proximal tumor excision could prolong the pati ents survival time. The early tumor excision is more effective.