联合脏器切除治疗324例进展期胃癌的疗效分析  

Combined evisceration for the treatment of advanced gastric carcinoma

作　　者：职康康[1] 顾渊[1] 罗天航[1] 聂明明[1] 毕建威[1] 

机构地区：[1]第二军医大学附属长海医院普外科一病区,上海200433

出　　处：《中华普外科手术学杂志（电子版）》2009年第2期37-39,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨联合脏器切除对伴有临近脏器侵犯或已有远处转移胃癌患者生存率的影响。方法对1998-2003年间收治324例伴有临近脏器侵犯或已有远处转移胃癌患者的临床资料进行回顾性分析。结果324例患者均经胃镜或术后病理证实为胃癌,其中91例(28.09%)行联合脏器切除扩大胃癌根治术;64例(19.75%)行姑息性手术;131例(40.43%)仅行化疗治疗;38例(11.73%)未行任何治疗。其1年的生存率分别为:76.92%(70例)、42.19%(27例)、46.56%(61例)和7.89%(3例);其3年的生存率分别为:36.26%(33例)、21.88%(14例)、19.84%(26例)和0%(0例);其5年的生存率分别为:20.88%(19例)、12.5%(8例)、14.50%(19例)和0%(0例)。联合脏器切除术后的并发症发生率为19.78%(18例),围手术期死亡6例,姑息性手术术后并发症仅为3.13%(2例)。结论对有临近脏器侵犯或已有远处转移的晚期胃癌患者,进行联合脏器切除仅能提高患者1年的生存率,无助于延长手术患者远期的生存时间,同时术后并发症多,大大增加了围手术期的危险性,在手术中需谨慎对待。Objective To assess the effect of combined evisceration for the treatment of gastric carcinoma with the invasion of closed organs or metastasis. Methods The clinical data of 324 patients with gastric carcinoma with the invasion of closed organs or metastasis who had been treated from 1998 to 2003 were analyzed retrospectively. Results The 324 patients were diagnosed by gastric endoscopy or postoperative pathologic examination. Ninety-one patients （28.09%） received combined evisceration, 64 （28.09%） palliative surgery, 131 （40.43%） chemotherapy only, and 38 （11.73 % ）non-treatment. The one-year survival rates were 76.92% （70 cases）, 42.19% （27 patients）, 46.56% （61） and 7.89% （3） respectively;the three-year survival rates were 6.26% （33 patients）, 21.88% （14）, 19.84% （26） and 0% （0）respectively; the five-year survival rates were 20.88% （ 19 patients）, 12.5% （ 8 ）, 14.50% （19） and 0% （0） respectively. The rate of postoperative complications after combined evisceration was 19.78% （ 18 patients）, and 6 patients died in the perioperative period, and the rate of postoperative complication after palliative surgery was 3.13% （2 patients）. Condusions Combined evisceration for the treatment of gastric carcinoma can improve the one-year survival rate, but does not work on the long-term rate. Moreover postoperative complications may increase the risk of perioperative treatment.

关 键 词：胃肿瘤 消化系统外科手术 联合脏器切除 存活率分析 

分 类 号：R735.2[医药卫生—肿瘤]