腹腔镜下行全胃和近侧胃切除治疗胃上部癌的疗效对比

Effect comparement between laparoscopy total radical gastrectomy and proximal radical gastrectomy for the treatment of upper gastric cancer

目的探讨腹腔镜下行全胃根治术治疗胃上部癌的临床价值。方法分析该院2007年10月至2010年10月收治胃上部癌患者143例,其中行全胃Roux-Y切除术79例(TG组),行近侧胃切除术64例(PG组),对比两组患者1、3年及各分期之间的生存率及术后并发症。结果 TG组患者1、3年总生存率为91.8%、62.4%,PG组为90.2%、44.3%,两组之间1年生存率差异无统计学意义(P>0.05),两组之间3年生存率差异有统计学意义(P<0.05)。两组之间3年各分期生存率比较,两组TNMⅠ、Ⅱ期患者3年生存率差异无统计学意义(P>0.05),TMNⅢ期患者3年生存率差异有统计学意义(P<0.05),两组患者术后总体并发症发生率差异无统计学意义(P>0.05)。结论腹腔镜下对胃上部癌患者行全胃根治术可明显提高中期疗效,同时不影响患者的术后并发症发生率及患者术后恢复。

Objective To evaluate the clinical value of laparoscopy total gastrectomy for the treatment of cancer of upper gastric cancer.Methods A total of 143 upper gastric cancer patients were collected in our hospital from October 2007 to October 2010,79 cases received laparoscopy-assisted total radical gastrectomy（group TG）,64 cases received laparoscopy-assisted proximal radical gastrectomy（group PG）,survival rate and postoperative complications of 1-year,3-year and different stages were compared between the two groups.Results The 1-year and 3-year survival rates of TG group were 93.0%,62.4%.and 91.3%,44.3%for PG group.the difference has not statistically significant in the 1-year survival rate（P〈0.05）and statistically significant in the 3-year survival rate（P〈0.05）.The 3-year different stages survival rate were compared in the two groups,The stageⅠ,Ⅱpatients in two group was not statistically significant in 3-year survival rate（P〉0.05）,but the stageⅢ patients in two group was statistically significant in 3-year survival rate（P〈0.05）.The postoperative complications in two group was not statistically significant（P〉0.05）.Conclusion Laparoscopy-assisted total radical gastrectomy for the treatment of upper gastric cancer could improve Mid-term therapeutic effects,and it does not affect the postoperative complication rate and postoperative recuperation.