CAJ | 학술논문

目的探讨保留迷走神经的近端胃癌根治手术的可行性及必要性.方法将2007年5月至2009年5月期间吉林大学第二医院收治的早期及部分T2期贲门癌患者32例,按随机数字表法对其进行前瞻性分组,分别施行保留迷走神经的近端胃癌根治术(保迷组16例)和传统近端胃癌根治术(对照组16例),比较两组患者的手术时间、围手术期并发症以及术后1年消化道症状、体质量、近期存活率、胃镜及腹部彩超结果.结果保迷组和对照组平均手术时间分别为2.8 h和2.5 h,术后并发症发生率分别为25.0%(4/16)和91.3%(5/16),差异均无统计学意义(P＞0.05).经1年以上的随访,两组均无复发和死亡病例.术后1年,保迷组患者餐后不适感(3例)、胆汁反流(3例)、萎缩性胃炎(1例)、胆囊病变(1例)均分别少于对照组(分别为12例、10例、9例和8例),两组比较,差异有统计学意义(P＜0.05和P＜0.01);体质量及习惯性腹泻情况保迷组亦优于对照组(P＜0.05).结论对于早期贲门癌患者,施行保留迷走神经的近端胃癌根治术不会降低其近期生存率,且可改善其生活质量.
목적 탐토보류미주신경적근단위암근치수술적가행성급필요성.방법 장2007년5월지2009년5월기간길림대학제이의원수치적조기급부분T2기분문암환자32례,안수궤수자표법대기진행전첨성분조,분별시행보류미주신경적근단위암근치술(보미조16례)화전통근단위암근치술(대조조16례),비교량조환자적수술시간、위수술기병발증이급술후1년소화도증상、체질량、근기존활솔、위경급복부채초결과.결과보미조화대조조평균수술시간분별위2.8 h화2.5 h,술후병발증발생솔분별위25.0%(4/16)화91.3%(5/16),차이균무통계학의의(P＞0.05).경1년이상적수방,량조균무복발화사망병례.술후1년,보미조환자찬후불괄감(3례)、담즙반류(3례)、위축성위염(1례)、담낭병변(1례)균분별소우대조조(분별위12례、10례、9례화8례),량조비교,차이유통계학의의(P＜0.05화P＜0.01);체질량급습관성복사정황보미조역우우대조조(P＜0.05).결론 대우조기분문암환자,시행보류미주신경적근단위암근치술불회강저기근기생존솔,차가개선기생활질량.
Objective To study the feasibility and influence of vagus nerve preservation in radical operation for proximal gastric cancer. Methods Thirty-two patients with early or T2 cardia cancer from May 2007 to May 2009 were enrolled and randomized into two groups, i.e. vagus nerve preservation group(n=16) and control group(n=16). Two groups were compared with regard to operative time, anastomotic fistula, digestive discomforts, body weight, survival rate, findings on gastroscope and abdominal ultrasonography. Results There were no statistically significant differences between the two groups in operative time (2.8 vs. 2.5 h), postoperative complications rate (25.0% vs. 31.3% ). No recurrence or mortality was observed after one-year follow-up. However, patients who underwent vagus nerve preservation had less postprandial discomforts(3 vs. 12 cases), bile reflux(3 vs. 10 cases), atrophic gastritis (1 vs. 9 cases), gallstones(1 vs. 8 cases), body mass index, and diarrhea(P＜0.05). Conclusion For patients with early gastric cancer, preservation of the vagus nerve during radical gastrectomy results in less complications and does not compromise patient survival.