两种术式对进展期胃上部癌术后辅助化疗耐受性的影响  

Effcts of two different surgical methods for proximal gastric cancer on adjuvant chemotherapy tolerance

作　　者：田君[1] 姚学权[2] 陈彻[2] 曹勤洪[2] 吴晓宇[2] 孙正[2] 陈志伟[2] 刘福坤[2] 

机构地区：[1]南京中医药大学第一临床医学院,江苏南京210046 [2]南京中医药大学附属江苏省中医院肿瘤外科,江苏南京210029

出　　处：《东南大学学报（医学版）》2014年第3期277-282,共6页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:比较近端胃切除和全胃切除对术后辅助化疗耐受性及完成率的影响。方法:回顾性分析142例胃上部癌病例不同术式对术后化疗的影响,观察严重不良反应的发生率、导致化疗终止的原因及内镜下反流性食管炎发病率及吻合口病变。结果:85例行近端胃切除,57例行全胃切除,术后化疗的完成率两组分别为21.2%和54.4%;化疗严重不良反应发生率近端胃切除组为48.2%,高于全胃切除组;导致化疗不耐受的原因中,近端胃切除组消化道不良反应所占比例为43.3%,尤其是呕吐反应的发生率达到35.8%,明显高于全胃切除组;近端胃切除组反流性食管炎及吻合口溃疡的发生率亦明显高于全胃切除组,差异均具有统计学意义。结论:近端胃切除组病例术后化疗不良反应发生率高,化疗完成率低,这一术式是否合理有待商榷及进一步研究。Objective：To examine the difference of the effcts of two different surgical methods for proximal gastric cancer on adjuvant chemotherapy tolerance and completion rates .Methods： Retrospectively research the influence of two different surgical methods for 142 patients of proximal gastric cancer on postoperative chemotherapy ,observe the incidence of serious adverse effects , the cause of the termination of chemotherapy , the incidence of reflux esophagitis and the anastomotic lesions by endoscopic observation .Results： 142 patients with proximal gastric cancer was divied into 57 cases of total gastrectomy group and 85 cases of proximal gastrectomy group .The completion rates of postoperative chemotherapy of the two groups were respectively 21.2% and 54.4%,and the incidence of serious adverse reaction of proximal gastrectomy group was 48 .2% which was much higher than total gastrectomy group.Gastrointestinal adverse reactions rate was accounted for 43.3%in proximal gastrectomy group , especially the vomiting reaction rate which was higher reached 35 .8% among all the causes of chemotherapy intolerance .The incidence reflux esophagitis and anastomotic ulcer in proximal gastrectomy group was also higher than total gastrectomy group , and all the difference had statistical significance .Conclusion：Proximal gastrectomy group get higher incidence of postoperative chemotherapy side effects but lower chemotherapy completion rate , so whether it is reasonable of this surgical methods need further research .

关 键 词：胃上部癌 辅助化疗 近端胃切除 反流性食管炎 

分 类 号：R735.2[医药卫生—肿瘤] R730.53[医药卫生—临床医学]