近端胃癌根治术治疗进展期近端胃癌的临床研究

Clinical Research of Radical Resection of Proximal Gastric Cancer in Patients with Advanced Proximal Gastric Cancer

目的:探讨全胃切除术与近端胃癌根治术治疗进展期近端胃癌(肿瘤直径﹥3 cm)的临床效果。方法:回顾性分析2005年7月-2010年7月本院收治的170例近端胃癌患者的临床资料,其中全胃切除术80(近端胃癌根治组),近端胃癌根治术90例(全胃切除组),调查比较两组术后28 d及5年生存率、术中指标、卫生经济学指标及术后并发症发生情况。结果:两组术后28 d及5年生存率、淋巴结清扫数目、总住院时间、总住院费用及术后并发症发生率比较,差异均无统计学意义(P>0.05);近端胃癌根治组手术时间、术中出血量及ICU住院时间均少于全胃切除组,比较差异均有统计学意义(P<0.05)。结论:近端胃癌根治术不影响进展期近端胃癌患者生存率,较全胃切除有手术时间短,术中出血量少及ICU住院时间短的优势。

Objective：To investigate the clinical effect of total gastrectomy and radical resection of proximal gastric cancer in patients with advanced proximal gastric carcinoma.Method：The clinical data of 170 patients with advanced proximal gastric cancer in our hospital from July 2005 to July 2010 were retrospectively analyzed.Among them 80 patients（total gastrectomy group） were given total gastrectomy,the other 90 patients（radical resection group） were given radical resection of proximal gastric cancer.The survival rates of 28-day and 5-year after the operation,the intraoperative indexes,the health economics indexes and the occurrence of postoperative complications were investigated and compared between the two groups.Result：The differences in the 28-day survival rate,5-year survival rate,number of lymph node dissection,total length of hospital stay,total cost and occurrence rates of postoperative complications of the two groups were not statistically significant（P〉0.05）.The operative time,intraoperative bleeding volume and the length of stay in ICU of the radical resection group were less than those of the total gastrectomy group,the differences were statistically significant（P〈0.05）.Conclusion：Radical resection of proximal gastric cancer has no effect on survival rate of advanced proximal gastric carcinoma.It is better than total gastrectomy in the aspects of operative time,intraoperative bleeding volume and the length of stay in ICU.