选择性D2^＋-D3胃癌根治术治疗进展期胃癌的临床研究  

A clinical study on selective D2^＋-D3 dissection in treating patients with advanced gastric carcinom

作　　者：王瑞海[1] 

机构地区：[1]新汶矿业集团莱芜中心医院外二科,山东省莱芜271103

出　　处：《中国基层医药》2009年第11期1966-1967,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析比较选择性D2^＋-D3胃癌根治术与传统的D2、D3根治术在进展期胃癌治疗效果。方法回顾性分析了118例进展期胃癌患者，分别行D1、D2、D3根治术和选择性D2^＋-D3胃癌根治术，对其5年生存率、手术时间、出血量、术后并发症等情况进行比较。结果选择性D2^＋-D3胃癌根治术组的5年生存率为40．00％，显著高于D2组的16．67％（P〈0．05），而与D3根治术的44．44％无差异。而术后并发症的发生情况并无明显差异，手术时间及手术相关死亡率较D3根治术减少。结论选择性D2^＋-D3胃癌根治术能明显提高Ⅲ期和部分Ⅳ期胃癌的生存期，手术创伤较D3术式小；能避免一部分病人不必要全胃切除，术后生活质量较好。Objective To study the rule of lymphatic metastasis of progressive gastric carcinoma aiming at the properscope of clearance of lymph nodes. Methods Retrospective analysis of 118 cases of advanced gastric cancer patients, respectively D1, D2, D3 radical mastectomy and selective D2^＋-D3 radical operation of gastric cancer,their 5-year survival rate,operation time,blood loss,postoperative complications,were compared. Results Selective D2^＋-D3 radical gastrectomy group of 5-year survival rate was 40. 00% ,significantly higher than the D2 group 16. 67% （P 〈 0. 05） ,while D3 and the radical mastectomy was no difference of 44. 44%. The post operative complications occurred in the circumstances there is no significant difference, surgery time and surgery-related mortality rate than the radical mastectomy to reduce the D3. Conclusion Selective D2^＋-D3 radical operation of gastric cancer can be improved and part of the period Ⅲ Ⅳ gastric cancer survival,but the trauma of surgery than patients D3-small;to avoid unnecessary part of the total gastrectomy patients, postoperative quality of life better. In the operation there is no simple and effective method of detecting lymph node metastasis, this method is a good approach.

关 键 词：胃肿瘤 肿瘤转移 外科手术 

分 类 号：R735[医药卫生—肿瘤]