泌尿系梗阻对行全胃切除术后胃癌患者的生存影响  

Effect of urinary obstruction on survival of patients with gastric cancer after total gastrectomy

作　　者：姚吉[1] 占鹏程[1] 程伟[1] 

机构地区：[1]杭州市萧山区第一人民医院泌尿科,浙江省杭州市311200

出　　处：《世界华人消化杂志》2017年第23期2144-2149,共6页World Chinese Journal of Digestology

摘　　要：目的探究出现泌尿系梗阻的全胃切除术后的胃癌患者的临床预后.方法回顾性分析2005-01/2015-06在杭州市萧山区第一人民医院诊断为胃癌并且接受全胃切除+Roux-en-Y吻合术术后出现泌尿系梗阻的患者,所有患者术后均定期来杭州市萧山区第一人民医院复查.统计分析患者的性别、年龄、泌尿系梗阻情况、化疗情况、胃癌病理类型、术后胃癌病理分期、转移情况、生存率,比较分析患者出现泌尿系梗阻时间、生存时间、无瘤生存时间、剩余生存时间.结果全胃切除术后泌尿系梗阻的胃癌患者28例.CT上首次发现泌尿系梗阻但无肿瘤复发证据的患者12例,术后出现泌尿系梗阻的中位时间为18 mo(6-48 mo),中位无瘤生存时间为6 mo(3-22 mo),中位剩余生存时间为8 mo(4-30 mo).CT上首次发现泌尿系梗阻时已伴随肿瘤复发征象的患者16例,术后出现泌尿系梗阻的中位时间为16 mo(3-42 mo),中位剩余生存时间为6 mo(3-24 mo).比较两组患者术后出现泌尿系梗阻及剩余生存时间,差异无统计学意义(P>0.05).结论全胃切除+Roux-en-Y吻合术继发泌尿系梗阻的患者预后较差,胃癌术后出现泌尿系梗阻的患者应考虑肿瘤复发转移.AIM To investigate the clinical prognosis of patientswith gastric cancer who develop urinary tract obstruction after total gastrectomy.METHODS Patients with urinary tract obstruction secondary to gastrectomy after total gastrectomy plus Roux-en-Y anastomosis at our department between January 2005 and June 2015 were retrospectively reviewed. All the patients came to our hospital regularly for review. We recorded their gender and age, urinary tract obstruction, chemotherapy, histological type of gastric cancer, gastric cancer stage, metastasis, survival rate, urinary tract obstruction time, survival time, tumor-free survival time, and the remaining survival time.RESULTS Twenty-eight patients with urinary tract obstruction secondary to total gastrectomy were included. In 12 cases, urinary tract obstruction was found for the first time with no evidence of tumor recurrence; their median time to development of urinary tract obstruction after gastrectomy was 18 mo（range, 6-48 mo）, median tumor-free survival time was 6 mo（3-22 mo）, and median remaining survival time was 8 mo（4-30 mo）. In 16 cases, urinary tract obstruction was found for the first time with evidence of tumor recurrence; their median time to development of urinary tract obstruction after gastrectomy was 16 mo（3-42 mo） and median remaining survival time was 6 mo（3-24 mo）. There was no significant difference in the median time to development of urinary tract obstruction after gastrectomy or the median remaining survival time（P 〉0.05）. The mediansurvival time of 28 patients with urinary tract obstruction after total gastrectomy was 30 mo（6-72 mo）.CONCLUSION The prognosis of patients with urinary tract obstruction after total gastrectomy is poor. In patients with urinary tract obstruction after total gastrectomy, tumor recurrence and metastasis should be considered.

关 键 词：胃癌 术后 泌尿系梗阻 全胃切除 

分 类 号：R735.2[医药卫生—肿瘤]