联合脾动脉干及脾切除在进展期胃底贲门癌根治术中的意义  

Effect of D2 radical resection combined with splenic artery and splenectomy in the radical resection of progressive gastric cardia cancer

作　　者：邰红武[1] 

机构地区：[1]江苏省海安县中医院,江苏海安226600

出　　处：《实用临床医药杂志》2012年第17期66-68,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨进展期胃底贲门癌D2根治术联合脾动脉干及脾切除术对患者预后的影响。方法回顾分析2000～2006年106例进展期胃底贲门癌No10、No11组淋巴结转移情况,以及对比采用D2根治术与D2根治术联合脾动脉干及脾切除术后的随诊情况。结果本组病例均为进展期胃底贲门癌,D2根治术组58例,其中中分化腺癌14例,低分化腺癌32例,黏液腺癌12例。PT2 22例,PT3 35例,PT4 3例,术后5年生存率24.1%(14/58);D2根治术联合脾动脉干及脾切除术组48例,其中中分化腺癌10例,低分化腺癌29例,黏液腺癌8例,鳞癌1例,PT2 18例,PT3 26例,PT4 4例,No10转移8例(16.7%),No11转移9例,术后5年生存率39.6%(19/48)。结论进展期胃底贲门癌在D2根治术基础上联合脾动脉干及脾切除可提高患者术后生存率。Objective To investigate the effect of D2 radical resection combined with splenic artery and splenectomy in the radical resection of progressive gastric cardia cancer. Methods A retrospective analysis of lymph node metastasis of groups Nol0 and Noll in 106 patients with progres- sive gastric cancer were conducted. The effects of 132 radical resection and D2 radical resection com- bined with splenic artery and splenectomy were compared in the follow-up. Results All the cases were progressive gastric cancer. D2 radical resection was conducted to 58 patients, including 14 cas- es of differentiated adcnocarcinoma, 32 cases of poorly differentiated adenocarcinoma, and 12 cases of mucinous ad There were 22 cases of PT2, 35 cases of PT3 and 3 cases of PT4 Postoperative 5 -year survival rate was 24.1% （14/58）. D2 radical gastrectomy combined with splenectomy splenic artery was conducted to 48 cases, including 10 cases of differentiated adenocar- cinoma, 29 cases of poorly differentiated adenocarcinoma, 8 cases of mucinous ade , and 1 case of squamous cell carcinoma. There were 18 cases of PT2, 26 cases of PT3, 4 cases of PT4, 8 cases （16.7%） of Nol0 metastases, and 9 cases of Noll metastasis. The postoperative 5 -year survival rate was 39.6 % （19/48）. Conclusion D2 radical resection combined with splenic artery and splenectomy in the radical resection of progressive gastric cardia cancer may improve the postop- erative survival rate.

关 键 词：胃底贲门癌 D2根治术 脾切除 生存率 

分 类 号：R573.7[医药卫生—消化系统]