根治性全胃切除与远端次全胃切除治疗M区胃癌的预后比较

Comparison of prognosis of the M-area stomach cancer by radical total gastrectomy and distal end total gastrectomy

目的：研究分析根治性全胃切除和远端次全胃切除治疗 M 区胃癌的预后效果。方法选取2013年8月至2015年8月收治的 M 区胃癌患者102例，将其随机分为两组，每组51例。对照组采用远端次胃全切除术，观察组采用全胃切除术。对比两组手术效果、局部复发率和远期生存率。结果观察组近切缘距离和清除淋巴结数目明显高于对照组，差异有统计学意义（P ﹤0.05）；两组远切缘距离比较差异未见统计学意义（P ﹥0.05）；观察组吻合口复发率、腹腔内复发率均低于对照组，差异有统计学意义（P ﹤0.05）；两组1年、3年生存率比较差异未见统计学意义（P ﹥0.05）；观察组5年生存率高于对照组，差异有统计学意义（P ﹤0.05）。结论与远端次全胃切除术比较，根治性全胃切除术治疗 M 区胃癌具有显著效果，可明显增加近切缘距离和清除淋巴结数目，降低局部复发率，提高患者远期生存率，改善预后，值得推广。

Objective To research and analyze the prognosis of the M-area stomach cancer by radical total gastrectomy and distal end total gastrectomy. Methods A total of 102 patient with M-area was treated by distal end total gastrectomy,the treatment group was treated by radical total gastrectomy. The operation result,local recurrence and long term survival rate were compared between the two groups. Results The distance of closed incisal edge and eliminated number of lumph node examined of the treat-ment group were significantly higher than those of the control group,the differences were significant（P ﹤0. 05）. The distance of forane incisal edge had no significant difference between the two groups（P ﹥0. 05）. The recurrence rate of anastomotic stoma and intraperitoneal of the treatment group were lower than that of the control group,the differences were significant（P ﹤ 0. 05）. The survival rates of 1 year and 3 years had no significant difference between the two groups（P ﹥ 0. 05）. The survival rate of 5 years of the treatment group was higher than that of the control group,the difference was significant（ P ﹤0. 05）. Conclusions Compared with the distal end total gastrectomy,the radical total gastrectomy for the M-area stomach cancer has remarkable effect. It can markedly increase the distance of closed incisal edge and eliminate number of lumph node examined,and reduce the local recurrence,improve the long term survival rate and the prognosis,and worthy for promotion.