全胃切除食管-空肠Roux-en-Y吻合术与近端胃切除胃-食管吻合术治疗进展期近端胃癌的临床效果  

Clinical effects of total gastrectomy for esophagus-jejunum Roux-en-Y anastomosis and proximal gastrectomy for gastric-esophageal anastomosis on patients with advanced proximal gastric cancer

作　　者：郑晨[1] 黄新[1] 李万林[1] 廖重五[1] 马苏[1] ZHENG Chen;HUANG Xin;LI Wan-lin;LIAO Chong-wu;MA Su(No.1 General Surgery Department,Xi＇an Central Hospital,Xi＇an 710003,China)

机构地区：[1]西安市中心医院普外一科,陕西西安710003

出　　处：《临床医学研究与实践》2018年第32期64-65,共2页Clinical Research and Practice

摘　　要：目的比较进展期近端胃癌患者采用全胃切除食管-空肠Roux-en-Y吻合术和近端胃切除胃-食管吻合术的临床效果。方法选取2012年6月至2015年6月我院110例进展期近端胃癌患者,按手术方式不同分为全胃切除组和近端胃切除组,各55例。比较两组患者的手术情况、并发症发生情况、Visick分级和3年生存率。结果全胃切除组手术时间明显长于近端胃切除组,淋巴结清扫数目明显多于近端胃切除组(P<0.05),两组患者住院时间无显著差异(P>0.05);两组患者切口感染、腹腔感染、吻合口瘘、反流性食管炎的发生率均无显著差异(P>0.05);两组患者Visick分级无显著差异(P>0.05);两组患者的3年生存率无显著差异(P>0.05)。结论全胃切除食管-空肠Roux-en-Y吻合术虽手术时间长,但淋巴结清扫数目多,建议临床上可优先选择该术式。Objective To compare the clinical effects of total gastrectomy for esophagus-jejunum Roux-en-Y anastomosisand proximal gastrectomy for gastric-esophageal anastomosis on patients with advanced proximal gastric cancer. Methods Atotal of 110 patients with advanced proximal gastric cancer in our hospital from June 2012 to June 2015 were selected anddivided into total gastrectomy group and proximal gastrectomy group, with 55 cases in each group. The surgical conditions,incidences of complication, Visick ratings and 3 -year survival rates of the two groups were compared. Results Theoperation time of the total gastrectomy group was significantly longer than that of the proximal gastrectomy group, thenumbers of lymph node dissection were significantly more than those of the proximal gastrectomy group（P〈0.05）. There wasno significant difference in the hospital stays between the two groups（P〉0.05）. There were no significant differences in theincidences of incision infections, abdominal infections, anastomotic fistula reflux esophagitis between the two groups （P〉0.05）. There was no significant difference in the Visick ratings between the two groups （P〉0.05）. There was no significantdifference in 3 -years survival rates between the two groups （P〉0.05）. Conclusion The operation time of the totalgastrectomy for esophagus-jejunum Roux-en-Y anastomosis is longer, but the numbers of lymph node dissection are more.It can be preferred in the clinical practices.

关 键 词：近端胃癌 食管-空肠Roux-en-Y吻合术 全胃切除 Visick分级 

分 类 号：R735.2[医药卫生—肿瘤]