两种联合切除方法治疗食管胃交界部腺癌的可行性及安全性比较

Comparison of the feasibility and safety of two combined resection methods in the surgical treatment of adenocarcinoma at the esophagogastric junction

目的对比两种联合切除方法治疗食管胃交界部腺癌的可行性及安全性。方法回顾性分析2015年1月至2017年10月接受手术治疗的89例食管胃交界部腺癌患者病例资料,根据术式不同分为两组,即A组(42例,胃根治性切除联合胰体尾和脾切除术)和B组(47例,胃根治性切除联合胰腺楔形切除术)。采用SPSS 23.0统计分析软件,胃肠道生存质量(GIQLI)及反流性疾病问卷表(RDQ)评分等计量资料以(x±s)表示,采用独立样本t检验;术后并发症、复发率等以率表示,采用χ^(2)检验;利用K-M法进行术后生存分析,Log-Rank进行检验。P<0.05为差异有统计学意义。结果A组术后并发症总发生率与B组相比(14.3%vs.17.0%);术后3个月两组GIQLI评分、RDQ评分差异均无统计学意义(P>0.05)。术后复发率:A组为23.8%(10/42),B组为25.5%(12/47),差异无统计学意义(P>0.05)。术后总生存率:A组为47.6%(20/42),B组为44.7%(21/47),差异无统计学意义(P>0.05)。结论胃切除联合根治性胰体尾和脾切除和联合胰腺楔形切除均具有可行性,两者术后并发症发生率、预后情况相似。

Objective To compare the feasibility and safety of two combined resection methods in the surgical treatment of adenocarcinoma of esophagogastric junction(AEG).Methods The clinical data of 89 patients with AEG from 2015 to 2017 were analyzed retrospectively.According to the type of operation,42 cases were divided into the group A who underwent radical gastrectomy combined with pancreatic body and tail and splenectomy,while 47 cases were divided into the of group B who received radical gastrectomy combined with pancreatic wedge resection.Statistical analysis were performed by using SPSS 23.0 software.The measurement data with normally distributed such as gastrointestinal quality of life(GIQLI)and reflux disease questionnaire(RDQ)score were expressed as,and were examined by using independent sample t test.The count data of complication and recurrence rate were expressed as percentage,and were examined by usingχ^(2) test.the survival was analyzed by log rank test.A P value of<0.05 was considered as statistically significant difference.Results There was no significant difference between the group A and the group B in terms of the total incidence of postoperative complications(14.3%vs.17.0%),the GIQLI and RDQ score on 3 months after operation,the recurrence and survival rate(P>0.05).ConclusionBoth the gastrectomy combined with radical pancreatic tail and splenectomy and combined pancreatic wedge resection are feasible with similar postoperative complications and prognosis.