全胃切除与近端胃切除治疗胃食管结合部腺癌的疗效比较

Clinical observationof total gastrectomy and proximal subtotal gastrectomy in treatment of adenocarcinoma of esophagogastric junction

目的比较全胃切除术(TG)和近端胃切除术(PG)治疗胃食管结合部腺癌(AEG)的疗效。方法回顾性分析2011年6月至2014年3月安徽省阜阳市第五人民医院普外二科收治的45例AEG患者的临床资料,依据手术方式不同分为TG组(23例)与PG组(22例),以手术时间、住院时间、术后并发症为近期指标,以术后反流、体质指数变化及术后1、3年生存率为远期指标,比较两组患者的疗效。结果两组患者手术时间、住院时间、术后并发症发生率及1年生存率、3年生存率的差异均无统计学意义(P>0.05);两组患者反流性食管炎发生率及体质指数增加值的差异有统计学意义(P<0.05)。结论 TG手术方式相对于PG在治疗进展期AEG患者中,其术后生活质量提高显著,是治疗进展期AEG较安全、满意的手术方式。

Objective Tocomparatively studythe far and near term efficacy oftotal gastrectomy and proximal gastrectomy in the treatment of adenocarcinoma of the esophagogastric junction（ AEG）. Methods The clinical data of 45 patients with AEG in the Second Department of General Surgery of Fifth People＇s Hospital of Fuyang of Anhui Provincefrom June 2011 to March 2014 were retrospectively analysed,including 23 cases of total gastrectomy group（ group TG） and 22 cases of proximal gastrectomy group（ group PG）. The observation index included operation time,intraoperative blood loss,hospitalization time and complications asthe recent index,as well as the postoperative regurgitation,body mass index changes,1 year and 3-year survival rate aslong-term target,then the curative effects of the two groups werecompared. Results There was no significant difference（ P〈0. 05） in operation time,hospital time,postoperative complication rate,1 year survival rate and 3-year survival ratebetween the two groups. There wassignificant difference in the incidence of reflux esophagitis and the increase in body mass index between the two groups（ P〈0. 05）. Conclusion Compared with proximal subtotal gastrectomy,the postoperative quality of life issignificantly improvedafter total gastrectomy for advanced AEG patients,which is a safe and satisfactory operation mode.