不同手术方式对胃中部癌患者预后的影响.docVIP

不同手术方式对胃中部癌患者预后的影响 　　[摘要] 目的 探讨不同胃切除手术方式对胃中部癌患者预后的影响。 方法 回顾性分析2010年1月～2012年12月武警北京总队医院收治的108例胃中部癌患者的临床资料，其中行开腹远端胃大部切除术患者58例（DG组），行开腹全胃切除术患者50例（TG组），比较两组患者临床病理资料、术中情况、并发症、术后5年的生存率；采用Cox回归模型进行危险因素分析。 结果 ①TG组肿瘤平均直径、浸润深度、淋巴结转移、TNM分期、WHO分期、Borrmann分型、分化程度比例等与DG组比较，差异均有统计学意义（P 0.05）。②TG组联合脏器切除比例、手术时间、并发症、清扫淋巴结数目及阳性数均高于DG组，差异均有统计学意义（P 0.05）。③DG组与TG组的中位生存期分别为61.5、77.2个月，1、3、5年累计生存率分别为95%、67%、59%和81%、63%、49%，差异无统计学意义（P 0.05）。Cox回归分析表明，根治程度、脏器侵犯、淋巴结转移为胃中部癌的独立预后因素（P 0.05）。 结论 对胃中部癌患者来说，预后不受手术方式的影响，只要能达到根治的目的，选择远端胃大部切除的手术方式是可行的。 　　[关键词] 胃肿瘤；中部；胃切除术；预后 　　[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210（2013）11（c）-0039-04 　　Influence of prognosis on patients with central gastric cancer by different ways of operation 　　LI Shaowei1 TAO Kaixiong2 　　1.Department of Surgery Ward One， Beijing Armed Police Corps Hospital， Beijing 100027， China； 2.Department of Gastrointestinal Surgery， Union Hospital Affiliated to Tongji Medical College， Huazhong University of Science and Technology， Hubei Province， Wuhan 430022， China 　　[Abstract] Objective To investigate the influence of prognosis on patients with central gastric cancer by different ways of operation. Methods 108 patients with central gastric cancer from January 2010 to December 2012 in Beijing Armed Police Corps Hospital were selected. 58 cases in DG group were treated with distal gastrectomy， while 50 cases in TG group were treated with total gastrectomy. Clinicopathologic data， intraoperative situation， complications， 5-year survival rates were compared between the two groups. The prognostic risk factors were evaluated by Cox multivariate analyses. Results ①The differences of tumor average diameter， infiltration depth， lymphatic metastasis， TNM stages， WHO stages， Borrmann types， differentiation proportion between TG group and DG group were statistically significant （P 0.05）. ②Multi-visceral resection rate， operation time， complications， the cleaning lymph node number and positive number of TG group were all higher than th