117例胃体癌手术切除方式分析.docVIP

117例胃体癌手术切除方式分析 　　【摘要】 目的：研究胃体癌选择不同切除方式对患者预后的影响。方法：回顾性分析郴州市第一人民医院普外科2003年1月-2008年1月收治的117例诊断为胃体癌且行根治性手术治疗的患者的临床资料，对比分析全胃切除术和远端胃大部切除术对患者预后的影响。结果：117例胃体癌患者中，行全胃切除术者85例，行远端胃大部切除术者32例。全胃切除术组的5年生存率为48.2%，低于远端胃大部切除术组的68.8%，但两组中同一临床分期的5年生存率差异无统计学意义（P0.05）。胃体癌的淋巴结转移、浸润深度及TNM分期是预后的独立因素（P0.05）。结论：在保证根治的前提下，切除方式不是患者预后的独立因素，胃体癌行远端胃大部切除术是可行的。 　　【关键词】 胃体癌； 切除方式； 预后 　　Analysis of Gastric Resection Methods of Middle One-third Gastric Cancer of 117 Cases/ZHOU Kai-kai， ZHANG Jian-wen， HUANG Ren-feng， et al.//Medical Innovation of China，2014，11（01）：003-005 　　【Abstract】 Objective：To analyze the impact of the differences of gastric resection on the prognosis of patients with middle one-third gastric cancer.Method：A retrospective analysis of 117 cases with middle one-third gastric cancer had underwent radical resection from January 2003 to January 2008 in department of general surgery of chenzhou first people’s hospital. The prognostic factors were compared between the total gastrectomy and distal gastrectomy by univariate and multivariate analyses.Result：In 117 cases of gastric cancer patients， 85 cases were given total gastrectomy， 32 patients were given distal gastrectomy. The five years survival rates of total gastrectomy and distal gastrectomy group were 48.2% and 68.8%. But the two groups of the same dinical staging of the five years survival rate showed no significant difference（P0.05）.The lymph node metastasis， depth of invasion and TNM stage were independent prognostic factors（all P0.05）.Conclusion：In the premise of ensured the radical， the prognosis of patients is not effected by the gastric resection， and distal gastrectomy is feasible. 　　【Key words】 Middle one-third gastric cancer； Gastric resection； Prognosis 　　First-author’s address：The First People’s Affiliated Hospital of South China University，Chenzhou 423000，China 　　doi：10.3969/j.issn.1674-4985.2014.01.002 　　胃癌是我国最常见的恶性肿瘤之一，每年新发病例46.3万，同期死于胃癌的病例约35.2万，死亡率居于第3位[1]。肿瘤的生长位置存在很大不同，欧美国家肿瘤多位于胃食管结合部，而亚洲患者以胃窦部和胃体肿瘤多