肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2008年
11期
760-763
,共4页
吴黎敏%徐卫萍%李航%林庆凡%李黎洪%张国烈
吳黎敏%徐衛萍%李航%林慶凡%李黎洪%張國烈
오려민%서위평%리항%림경범%리려홍%장국렬
胃肿瘤%外科于术%治疗
胃腫瘤%外科于術%治療
위종류%외과우술%치료
Stomach neoplasms%Surgical procedures,operative%Therapy
目的 探讨胃癌手术治疗的方法.方法 回顾件分析1992年1月至2004年12月间1072例患者行外科手术治疗的临床资料.结果 手术切除922例(86%),其中根治性手术783例(73%),姑息性切除139例(12.9%),在所有切除的手术中,近端胃大部切除239例,远端胃大部切除361例,全胃切除322例,其中空肠间置代胃132例,空肠P襻Roux-y代胃术200例,联合脏器切除92例,手术探查150例.D1手术86例,D2手术592例,D3手术99例,D4手术6例.TNM分期:Ⅰ期102例,Ⅱ期269例,ⅢA期378例,ⅢB期172例,Ⅳ期151例,Ⅲ、Ⅳ期患者占65.4%.总的1、3、5年生存率分别为74.6%、61.7%、41.1%.其中根治性手术的1、3、5年生存率为83.1%、65.2%、45.8%.手术死亡率0.5%,手术并发症发生率4.9%.结论 根治性手术切除是治疗胃癌的关键,术式的选择和代胃方式、联合脏器切除、预防切端癌残留和于术并发症、术后辅助性化疗可提高生存率和生存质量.
目的 探討胃癌手術治療的方法.方法 迴顧件分析1992年1月至2004年12月間1072例患者行外科手術治療的臨床資料.結果 手術切除922例(86%),其中根治性手術783例(73%),姑息性切除139例(12.9%),在所有切除的手術中,近耑胃大部切除239例,遠耑胃大部切除361例,全胃切除322例,其中空腸間置代胃132例,空腸P襻Roux-y代胃術200例,聯閤髒器切除92例,手術探查150例.D1手術86例,D2手術592例,D3手術99例,D4手術6例.TNM分期:Ⅰ期102例,Ⅱ期269例,ⅢA期378例,ⅢB期172例,Ⅳ期151例,Ⅲ、Ⅳ期患者佔65.4%.總的1、3、5年生存率分彆為74.6%、61.7%、41.1%.其中根治性手術的1、3、5年生存率為83.1%、65.2%、45.8%.手術死亡率0.5%,手術併髮癥髮生率4.9%.結論 根治性手術切除是治療胃癌的關鍵,術式的選擇和代胃方式、聯閤髒器切除、預防切耑癌殘留和于術併髮癥、術後輔助性化療可提高生存率和生存質量.
목적 탐토위암수술치료적방법.방법 회고건분석1992년1월지2004년12월간1072례환자행외과수술치료적림상자료.결과 수술절제922례(86%),기중근치성수술783례(73%),고식성절제139례(12.9%),재소유절제적수술중,근단위대부절제239례,원단위대부절제361례,전위절제322례,기중공장간치대위132례,공장P반Roux-y대위술200례,연합장기절제92례,수술탐사150례.D1수술86례,D2수술592례,D3수술99례,D4수술6례.TNM분기:Ⅰ기102례,Ⅱ기269례,ⅢA기378례,ⅢB기172례,Ⅳ기151례,Ⅲ、Ⅳ기환자점65.4%.총적1、3、5년생존솔분별위74.6%、61.7%、41.1%.기중근치성수술적1、3、5년생존솔위83.1%、65.2%、45.8%.수술사망솔0.5%,수술병발증발생솔4.9%.결론 근치성수술절제시치료위암적관건,술식적선택화대위방식、연합장기절제、예방절단암잔류화우술병발증、술후보조성화료가제고생존솔화생존질량.
Objective To analyze, the surgical treatment for gastric cancer. Methods Clinical data of 1072 patients with gastric cancer were analyzed retrospectively. Results The main clinical manifestations included upper abdominal pain(671 cases), difficulty in swallow(311 cases), appetite loss(187 cases),wasting or weight loss(158 cases), nausea and vomiting(97 cases), distention or upset(178 cases) and hematochezia (116 cases). 922 of 1072 patients (86 %) underwent resection, including 783 radical operation and 139 pauiative operation, including 239 proximal gastrectomy,361 distal gastrectomy and 322 total gastrectomy (jejunal interposition in 132 cases and "P"-Roux-en-y reconstruction in 200 cases). 92 cases received combined organs resection while 150 cases received exploratory laparotomy among them. D1 lymphadenectomy was performed for 86 cases and D2 lymphadenectomy 592 cases, D3 99 cases, and D4 6 cases. Stage Ⅰ accounted for 102 cases and stage Ⅱ269 cases, ⅢA 378 cases, ⅢB 172 cases, and stage Ⅳ 151 cases. The 1, 3,5 year overall survival rate were 74.6 %, 61.7 % and 41.1% in all cases but 83.1%, 65.2 % and 45.8 % in the group under radical treatment of gastric carcinoma. Conclusion To increase the survival rate and improve the quality of life,we shall pay attention to surgical procedure,digestive tract reconstruction,prevention of positive stump and postoperative complications in gastric cancer.
