不同清扫方式根治术治疗进展期胃癌的疗效和安全性

Efficacy and safety of radical gastrectomy with different cleaning methods for advanced gastric cancer

目的探讨不同清扫方式根治术治疗进展期胃癌的疗效和安全性。方法选取2014年5月—2018年5月收治的进展期胃癌患者150例,依据随机数字表法分为D0、D2、D3组,每组50例,D0组给予姑息性清扫(D0)方式根治术治疗,D2组给予标准性清扫(D2)方式根治术治疗,D3组给予扩大性清扫(D3)方式根治术治疗,比较3组患者的疗效和安全性。结果 D2、D3组住院时间、并发症率低于D0组,D0、D2组手术时间比较差异无统计学意义(P> 0.05),D2、D3组术中出血量明显低于D0组,D3组手术时间明显高于D0、D2组,D3组淋巴结清扫数明显高于D2,D2组淋巴结清扫数明显高于D0组,差异有统计学意义(P <0.05);D0、D2、D3组术后1、2年生存率比较,差异无统计学意义(P> 0.05),D3组术后3年生存率明显高于D2组,D2组术后3年生存率明显高于D0组,差异有统计学意义(P <0.05)。结论 D2、D3方式根治术治疗进展期胃癌具有良好的疗效及安全性,其中行D3方式根治术治疗的患者生存预后更佳,值得临床推广。

Objective To discuss the efficacy and safety of radical gastrectomy with different cleaning methods for advanced gastric cancer.Methods 150 patients with advanced gastric cancer were selected from May2014 to May 2018 and divided into D0,D2 and D3 groups by the random number table method,with 50 cases in each group.D0 group was given palliative cleaning(D0)radical gastrectomy,D2 group was given standard radical cleaning(D2)radical gastrectomy and D3 group was given expansion cleaning(D3)radical gastrectomy,and the efficacy and safety were compared between the three groups.Results The hospitalization time and complication rate in D2 and D3 were lower than that D0;a comparison of the operation time between D0 and D2 showed no significant difference(P>0.05);the intraoperative bleeding volume in D2 and D3 were significantly lower than that in D0;the operation time in D3 were significantly longer than that in D0 and D2;the lymph node clearance in the D3 group was significantly higher than that in the D2 group,the lymph node clearance in D2 was significantly higher than that in D0 and the difference was statistically significant(P<0.05).A comparison of the postoperative 1 and 2 year survival rates between D0,D2 and D3 showed no statistically significant difference(P>0.05);the postoperative 3 year survival rate in D3 was significantly higher than that in D2;the postoperative 3 year survival rate in D2 was significantly higher than that in the D0 group,with the difference being statistically significant(P<0.05).Conclusion D2 and D3 radical gastrectomy had good efficacy and safety for advanced gastric cancer,of which D3 radical gastrectomy had the best survival prognosis and is thus worth further clinical promotion.