胃癌根治术后患者临床情况分析

Analysis of clinical conditions in patients with gastric cancer after radical gastrectomy

目的探讨胃癌根治术后患者复发时间、复发类型及再手术后的临床效果。方法选取2013年8月至2018年8月间上海杨思医院收治的102例胃癌根治术后复发患者,调查患者的一般情况、复发类型和生存时间,分析复发时间和根治性再手术切除率的相关性。结果患者复发时间主要在首次术后2年(72. 5%),复发类型主要为腹腔广泛性转移复发与腹膜复发(41. 2%)。复发时间为首次术后2年、3年和5年及以上患者的根治性再手术切除率分别为18. 9%(14例)、50. 0%(2例)和66. 7%(2例),复发时间和根治性再手术切除率之间呈正相关关系(P <0. 05)。接受再手术治疗患者的2年、3年和5年生存率分别为53. 8%、28. 2%和20. 5%,均高于未接受再手术治疗患者8. 3%、0和0,差异均有统计学意义(均P <0. 05)。根治性再手术患者的1年、2年、3年和5年生存率均高于非根治性再手术患者,差异均有统计学意义(均P <0. 05)。结论胃癌根治术后患者复发时间主要在首次术后2年,复发类型主要为腹腔广泛性转移复发与腹膜复发,再手术后临床效果好。

Objective To analyze the recurrence time,recurrence type and postoperative efficacy in patients with gastric cancer after radical gastrectomy. Methods A total of 102 patients with recurrent gastric cancer after radical gastrectomy who admitted to Shanghai Yangsi Hospital from August 2013 to August 2018 were randomly selected. The general condition,recurrence type and survival time of all patients were investigated. The correlation between recurrence time and resection rate of radical gastrectomy was analyzed. Results Most recurrence occurred 2 years after the first operation( 72. 5%). The main types of recurrence were extensive abdominal metastasis and peritoneal recurrence( 41. 2%). The resection rates of radical reoperation for patients with recurrence time of 2,3,5 years or more after the first operation were18. 9%( 14 patients),50. 0%( 2 patients) and 66. 7%( 2 patients),respectively. There was significant positive correlation between the recurrence time and the resection rate of radical reoperation( P < 0. 05).The 2-year,3-year and 5-year survival rates for patients receiving reoperation were 53. 8%,28. 2% and20. 5%,respectively,which were significantly higher than patients without reoperation 8. 3%,0 and 0,respectively( all P < 0. 05). The 1-year,2-year,3-year and 5-year survival were significantly higher in patients undergoing radical reoperation than patients without radical reoperation( all P < 0. 05).Conclusion The recurrence time of gastric cancer for patients after radical gastrectomy is mainly 2 years after the first operation. The main types of recurrence are extensive abdominal metastasis and peritoneal recurrence. The clinical efficacy of reoperation is good.