不同切除范围对M区胃癌患者预后的影响  

The influence of different resection range on prognosis of patients with gastric cancer in M area

作　　者：朱海涛[1] 郑志超[1] 张剑军[1] 刘晓平[1] 刘阳[1] 杨巍[1] 刘勇[1] 张涛[1] 赵岩[1] 刘彦擎[1] 苏晓晖[1] 谷小虎[1] 

机构地区：[1]辽宁省肿瘤医院胃外科,沈阳110042

出　　处：《肿瘤研究与临床》2015年第3期165-167,共3页Cancer Research and Clinic

摘　　要：目的 比较M区胃癌患者行根治性全胃切除术及根治性远端次全胃切除术的局部复发率和远期生存率.方法 回顾性分析2007年3月至2008年3月间在辽宁省肿瘤医院胃外科手术治疗的M区胃癌106例,其中采取根治性全胃切除术55例,远端次全胃切除术51例,分为2组,比较术后局部复发率的差异以及术后1、3、5年生存率差异.结果 全胃切除术组与次全胃切除术组比较,前者吻合口复发率更低[3.64％（2/55）比17.65 ％（9/51）,P=0.018],腹腔内复发率同样也更低[25.45％（14/55）比45.10％（23/51）,P=0.034].全胃切除术组术后1、3、5年生存率分别为92.73％、74.55％、58.18％,次全胃切除术组1、3、5年生存率分别为88.24％ 、66.67％、35.29％.两组1、3年生存率差异无统计学意义（P＞0.05）,而5年生存率差异有统计学意义（P=0.018）.结论 针对M区胃癌,全胃切除术较次全胃切除术能够获得更低的局部复发率和更高的5年生存率.推荐采用全胃切除术治疗M区胃癌.Objective To compare the survival rate and recurrence between the patients with gastric cancer in M area treated with radical total gastrectomy and radical distal subtotal gastrectomy.Methods Data of 106 cases of the patients with gastric cancer in M area were analyzed retrospectively from March 2007 to March 2008 in Department of Gastric Surgery in Liaoning Cancer Hospital.55 cases treated by radical total gastrectomy （total gastrectomy group） and 51 cases by distal subtotal gastrectomy （subtotal gastrectomy group）.Differences of postoperative local recurrence rates and 1,3,5-year survival rates between both groups were compared.Results The anastomotic recurrence rate of total gastrectomy group was lower than that of subtotal gastrectomy group （3.64 % vs 17.65 %,P =0.018）,the intraperitoneal recurrence rate was also lower （25.45 % vs 45.10 %,P =0.034）.The postoperative 1-year survival rates of total gastrectomy group and subtotal gastrectomy group were 92.73 % and 88.24 %,3-year survival rates were 74.55 % and 66.67 %,the 5-year survival rates were 58.18 % and 35.29 %,respectively.The differences of 1,3-year survival rates did not show statistical significance （P 〉 0.05）,while that of the 5-year survival rates showed statistical significance （P =0.018）.Conclusion For gastric cancer in M area,total gastrectomy is recommended for the treatment,which is helpful to reduce the local recurrence rate and improve the 5-year survival rate.

关 键 词：胃肿瘤 M区 手术 

分 类 号：R735.2[医药卫生—肿瘤]