不同年龄层次进展期胃癌开腹远端胃癌D2根治术的疗效及随访分析

Analysis of the curative effect and follow-up of open D2 radical operation for distal gastric cancerin patients with advanced gastric cancer of different ages

目的:分析不同年龄层次进展期胃癌患者行开腹远端胃癌D2根治术的疗效及随访情况。方法:以本院2009年5月~2011年10月行开腹远端胃癌D2根治术的100例进展期胃癌患者为研究对象,根据不同年龄层次将其分为A(年龄<70岁)、B(年龄≥70岁)两组,评价两组手术效果,术后随访5年,比较两组1年、3年、5年生存率。结果:A组营养不良风险、术前合并症比率分别为14.29%、46.03%,均显著低于B组的35.14%、70.27%;A组术后下床活动时间明显早于B组,住院时间明显短于B组,差异有统计学意义;A组肺部感染发生率7.94%显著低于B组的21.62%;A组5年生存率60.32%显著高于B组的37.84%;两组手术时间、术中出血量、淋巴结清扫总数、1年及3年生存率比较差异无统计学意义。结论:高龄(≥70岁)进展期胃癌患者行开腹远端胃癌D2根治术后恢复相对慢,肺部感染发生几率大,这可能与高龄患者存在营养不良风险、合并症多等有关;且年龄影响患者预后(5年生存率),但并非独立危险因素。

Objective To analyze the curative effect and follow-up of open D2 radical operation in patients with advanced gastric cancer of different ages. Methods One hundred patients with advanced gastric cancer who underwent open D2 radical operation for for distal gastric cancer in our hospital between May 2009 and October 2011 were selected as study subjects and were divided into group A(< 70 years old) and group B(≥70 years old) according to age. The surgical effects were evaluated. After operation, the patients were followed up for 5 years, and the 1-year, 3-year and 5-year survival rates were compared between the two groups. Results The ratios of risk of malnutrition and preoperative complications in group A(14.29%, 46.03%) were significantly lower than those in group B(35.14%, 70.27%); the postoperative time of leaving bed in group A was significantly earlier than group B group, and the length of stay was significantly shorter than group B; The incidence rate of pulmonary infection in group A(7.94%) was significantly lower than that in group B(21.62%). The 5-year survival rate of group A(60.32%) was significantly higher than that in group B(37.84%); There was no significant difference in the operation time, bleeding volume, total number of lymph node removed, 1-year and 3-year survival rates between the two groups. Conclusion Elderly(≥70 years old) patients with advanced gastric cancer recover relatively slowly after open D2 radical operation for distal gastric cancer and the risk of pulmonary infection is high, which may be related to the risk of malnutrition and complications in elderly patients; Age affects the prognosis ofpatients(5-year survival rate), but it is not an independent risk factor.