腹腔镜下全胃切除术对胃上部肿瘤患者远期生存率影响.docVIP

腹腔镜下全胃切除术对胃上部肿瘤患者远期生存率影响 　　【摘要】 目的 探讨腹腔镜下全胃切除术对胃上部肿瘤患者远期生存率的影响。方法 100例胃上部肿瘤患者， 随机分为观察组（55例）和对照组（45例）。对照组患者给予腹腔镜下近侧胃切除术， 观察组给予腹腔镜下全胃切除术。观察并记录两组患者手术后的并发症发生情况及术后1、3、5年生存率。结果 观察组患者术后并发症发生率10.9%与对照组11.1%比较差异无统计学意义（P0.05）。两组患者中肿瘤分期为Ⅰ、Ⅱ期的患者， 其术后1、3、5年生存率比较， 差异无统计学意义（P0.05）；两组Ⅲ期患者术后1年生存率比较， 差异无统计学意义（P0.05）， 3、5年生存率比较， 差异有统计学意义（P0.05）。结论 腹腔镜下全胃切除术对胃上部肿瘤患者术后并发症发生率及近期生存率影响不大， 但是可以提高Ⅲ期患者远期生存率。 　　【关键词】 腹腔镜；全胃切除术；胃上部肿瘤；远期生存率 　　DOI：10.14163/j.cnki.11-5547/r.2016.15.003 　　【Abstract】 Objective To investigate influence by laparoscopic total gastrectomy on long-term survival rate in upper stomach tumor patients. Methods A total of 100 upper stomach tumor patients were randomly divided into observation group （55 cases） and control group （45 cases）. The control group received laparoscopic proximal gastrectomy， and the observation group received laparoscopic total gastrectomy. Postoperative complications and 1， 3， 5 years survival rates of the two groups were observed and recorded. Results There was no statistically significant difference of postoperative incidence of complications as 10.9% and 11.1% between the observation group and the control group （P0.05）. The difference of 1， 3， 5 years survival rates of stages Ⅰ and Ⅱ patients had no statistical significance between the two groups （P0.05）. The difference of 1-year survival rate of stage Ⅲ patients had no statistical significance between the two groups （P0.05）， and their differences of 3 and 5 years survival rates had statistical significance （P0.05）. Conclusion Laparoscopic total gastrectomy shows no precise influence on postoperative incidence of complications and short-term survival rate， while it can improve long-term survival rate in stage Ⅲ patients. 　　【Key words】 Laparoscope； Total gastrectomy； Upper stomach tumor； Long-term survival rate 　　胃癌是我国常见的一种恶性肿瘤， 其发病率和死亡率均居各类肿瘤前列[1]。胃上部癌由于特殊的解剖位置， 早期症状很不典型， 给临床诊治带来困难[2]。当胃癌发展到进展期时患者常见的临床表现是：疼痛、体重下降、吞咽困难， 严重的影响患者的生活和工作[3]。目前临床上常用的治疗方法为手术治疗， 包括全胃切除术和近侧胃切除术[4]。本文探讨腹腔镜下全胃切除术对胃上部肿