高龄胃癌患者合理的淋巴结清扫范围探讨  

The Proper Range of Lymphadenectomy for Elderly Patients with Gastric Cancer

作　　者：陈建新[1] 林伟[1] 陈金坤[1] 郭健[1] 刘惠滨[1] 

机构地区：[1]莆田学院附属医院胃肠外一科,福建莆田351100

出　　处：《莆田学院学报》2016年第5期22-26,共5页Journal of putian University

基　　金：福建省卫生厅中青年重点项目(2013-ZQN-ZD-30)

摘　　要：探讨不同淋巴结清扫范围对高龄胃癌患者术后恢复及生存的影响。研究2000—2012年的1293例胃癌手术患者,其中312例高龄患者。根据清扫的淋巴结总数,分为非广泛淋巴结清扫组和广泛淋巴结清扫组。对比高龄患者和年轻患者以及不同清扫范围的高龄患者的围手术期数据及生存率。结果:高龄患者有着更高的麻醉评分、术后并发症和死亡率(P<0.05);在高龄患者中,广泛淋巴结清扫组比非广泛淋巴结清扫组手术时间更长、术中出血量更多及术后30d内并发症发生率更高(P<0.05),而术后5a生存率无明显差别(P>0.05)。结果表明,广泛的淋巴结清扫对高龄患者没有长期生存获益,反而增加术后短期并发症发生率。The paper evaluated peri-operation outcomes and survival of elderly gasric cancer patients with different ranges of lymphadenectomy. A total of 1293 patients with gastric cancer who underwent resection of gastric cancer between 2000 and 2012 were enrolled in the study, among which there were 312 elderly patients. The patients were categorized into limited lymphadenectomy group or extended lymphadenectomy group according to the total number of lymph nodes. Elderly patients and young patients, and post- operation outcomes and survival rate were compared between two groups. The elderly were presented with a higher ASA score, more postoperation complications and mortality（P〈 0.05）. Among the elderly, extended lymphadenectomy group presented longer operation time, more amounts of intraoperation bleeding and more postoperation mobidity within 30 days compared with limited lymphadenectomy（P〈 0.05）, while there is no significant difference in postoperative 5a survival rate（P〉 0.05）. For the elderly, an extended lymphadenectomy did not improve long-term survival but increase postoperation complications.

关 键 词：胃癌 高龄患者 淋巴结切除术 

分 类 号：R735.2[医药卫生—肿瘤]