联合脏器切除术在进展期胃癌治疗中的应用

Using combined organs resection to treat advanced gastric cancer

目的 了解联合脏器切除术在进展期胃癌中的应用效果。方法 对我科 1994年 9月- 1997年 3月施以联合脏器切除术的 4 9例进展期胃癌病人的临床资料进行回顾性分析 ,并对照同时期未行根治手术和接受标准胃癌根治术的病人。结果 联合脏器切除术治疗进展期胃癌 1年、3年、5年生存率分别为 77.5 5 %、30 .6 1%、14 .2 9% ,明显高于同时期姑息手术和剖腹探查组 (1年生存率比较P <0 .0 1,3年、5年生存率比较P <0 .0 5 ) ,并发症发生率 12 .2 4 % ,与标准胃癌根治术组无明显差异 (P >0 .0 5 )。结论 联合脏器切除术治疗进展期胃癌能明显改善病人预后 ,延长生存期 ,且相对安全。强调适应证的掌握和手术方式的选择 。

Objective To evaluate the effect of combined organs resection on treating advanced gastric cancer (AGC). Methods The clinical data of 49 patients with AGC who underwent combined organs resection from September 1994 to March 1997 were analysed retrospectively, and were compared with those of the patients who underwent noncurative resection and standard radical resection over the same course. Results The 1-year,3-year and 5-year survival rate of patients treated by combined organs resection was 77.55%, 30.61% and 14.29% respectively, which was significantly higher than that of noncurative resection (1-year P<0.01, 3-year, 5-year P<0.05). There was no statistical difference in the incidence of surgical complications between combined organs resection and standard radical resection (P>0.05).The former was 12.24%. Conclusions Using combined organs resection to treat AGC can effectively improve patients' prognosis and prolong survival period. This operation is safe. Controlling the operation indications and selecting the operation types should be emphasized. It is important to pay attention to the perioperative care.