胃底贲门癌根治性切除与扩大根治性切除的疗效对比  

Long term therapeutic effects of extended radical resection and radical resection of cancer of cardia and stomach fundus

作　　者：黄昌明[1] 张祥福[1] 卢辉山[1] 郑知文[1] 吴心愿[1] 官国先[1] 王川[1] 周永建[1] 张建中[1] 郑朝晖[1] 

机构地区：[1]福建医科大学附属协和医院肿瘤科,福州350001

出　　处：《中华外科杂志》2000年第1期55-57,共3页Chinese Journal of Surgery

摘　　要：目的　探讨胃底贲门癌根治性手术的最佳范围。　方法　对 418例胃底贲门癌患者施行根治性手术 ,其中扩大根治性切除 192例 (扩大组 ) ,Ⅰ期 11例 ,Ⅱ期 40例 ,Ⅲ期 12 1例 ,Ⅳ期 2 0例 ;根治性切除 2 2 6例 (根治组 ) ,Ⅰ期 19例 ,Ⅱ期 5 3例 ,Ⅲ期 131例 ,Ⅳ期 2 3例。对 2组患者术后 5、10年生存率进行对照分析。　结果　 2种术式的 5、10年生存率 :Ⅰ、Ⅱ期患者相似 ,差异无显著性意义 (P>0 0 5 ) ;而Ⅲ期患者扩大组 5、10年生存率较根治组分别提高了 14 2 %和 15 9% ,差异具有显著性意义 (P <0 0 5 ) ;Ⅳ期患者 5、10年生存率虽有提高 ,但与根治组相比差异无显著性意义 (P >0 0 5 )。　结论　对于胃底贲门癌已浸润浆膜层或第 2站淋巴结有转移的Ⅲ期患者 ,均应行扩大根治性切除术 ,以彻底清扫脾门、脾动脉干淋巴结 ,提高患者的远期生存率。Objective[WT5”BZ] To study the best range of radical resection in the treatment of cancer of the cardia and fundus of stomach. [WT5”HZ]Methods[WT5”BZ] 418 patients with cancer of the cardia and fundus of stomach underwent radical resection. Of them 192 were treated by extended radical resection(extended group), and 226 by radical resection (radical group).The 5 year and 10 year survival rates were followed up and compared in the two groups. [WT5”HZ]Results[WT5”BZ] Analysis failed to demonstrate significant difference between the two operations for TNM stage I and II ( P >0 05). For stage III, however, the 5 year and 10 year survival rates in the extended group increased by 14 2% and 15 9% as compared with those in the radical group( P <0 05). The two groups survival rates were similar for stage IV( P >0 05). [WT5”HZ]Conclusions[WT5”BZ] To completely clean the lymph nodes of splenic hilus and artery and improve long term survival rate, extended radical resection including spleen and body and tail of the pancreas should be recommended for stage III patients with cancer of the cardia and fundus of stomach when their serosa was involved or lymph node metastasis took place. [WT5”HZ]

关 键 词：胃肿瘤 外科手术 预后 胃底贲门癌 

分 类 号：R735.2[医药卫生—肿瘤]