中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2009年
9期
673-676
,共4页
韩方海%詹文华%何裕隆%黄奕华%陈正煊%董文广%石汉平%蔡世荣%李洪明
韓方海%詹文華%何裕隆%黃奕華%陳正煊%董文廣%石漢平%蔡世榮%李洪明
한방해%첨문화%하유륭%황혁화%진정훤%동문엄%석한평%채세영%리홍명
胃肿瘤%淋巴结切除术%预后
胃腫瘤%淋巴結切除術%預後
위종류%림파결절제술%예후
Stomach neoplasms%Lymph node excision%Prognosis
目的 比较血管鞘内、外淋巴结清扫对胃癌患者临床结局的影响.方法 回顾性分析1994年6月至2005年4月外科治疗的759例胃癌患者的临床资料,其中根治性切除627例,并分别采取血管鞘内淋巴结清扫(VLND组,215例)和血管鞘外淋巴结清扫(NVLND组,412例).分析比较两组不同的淋巴结清扫方法的手术时间、术中失血量、外科并发症等资料,并比较分析两组术后生存率差异.结果 根治性切除手术后5年和10年生存率比较:VLND组分别为55.4%和51.2%,NVLND组分别为39.1%和36.8%,两组差异均有统计学意义(P<0.05).VLND组中N0～N2、T2～T4、Ib～Ⅳ期胃癌患者术后5、10年累积生存率均显著高于NVLND组.而术中输血量、手术时间、手术并发症、术后并发症两组差异无统计学意义.结论 对于进展期胃癌患者,血管鞘内淋巴结清扫可提高术后生存率,不增加手术时间和术后并发症,是安全的淋巴结清扫技术.
目的 比較血管鞘內、外淋巴結清掃對胃癌患者臨床結跼的影響.方法 迴顧性分析1994年6月至2005年4月外科治療的759例胃癌患者的臨床資料,其中根治性切除627例,併分彆採取血管鞘內淋巴結清掃(VLND組,215例)和血管鞘外淋巴結清掃(NVLND組,412例).分析比較兩組不同的淋巴結清掃方法的手術時間、術中失血量、外科併髮癥等資料,併比較分析兩組術後生存率差異.結果 根治性切除手術後5年和10年生存率比較:VLND組分彆為55.4%和51.2%,NVLND組分彆為39.1%和36.8%,兩組差異均有統計學意義(P<0.05).VLND組中N0～N2、T2～T4、Ib～Ⅳ期胃癌患者術後5、10年纍積生存率均顯著高于NVLND組.而術中輸血量、手術時間、手術併髮癥、術後併髮癥兩組差異無統計學意義.結論 對于進展期胃癌患者,血管鞘內淋巴結清掃可提高術後生存率,不增加手術時間和術後併髮癥,是安全的淋巴結清掃技術.
목적 비교혈관초내、외림파결청소대위암환자림상결국적영향.방법 회고성분석1994년6월지2005년4월외과치료적759례위암환자적림상자료,기중근치성절제627례,병분별채취혈관초내림파결청소(VLND조,215례)화혈관초외림파결청소(NVLND조,412례).분석비교량조불동적림파결청소방법적수술시간、술중실혈량、외과병발증등자료,병비교분석량조술후생존솔차이.결과 근치성절제수술후5년화10년생존솔비교:VLND조분별위55.4%화51.2%,NVLND조분별위39.1%화36.8%,량조차이균유통계학의의(P<0.05).VLND조중N0～N2、T2～T4、Ib～Ⅳ기위암환자술후5、10년루적생존솔균현저고우NVLND조.이술중수혈량、수술시간、수술병발증、술후병발증량조차이무통계학의의.결론 대우진전기위암환자,혈관초내림파결청소가제고술후생존솔,불증가수술시간화술후병발증,시안전적림파결청소기술.
Objective To evaluate and compare the results of vagina vasorum lymph node dissection (VLND) and non-vagina vasorum lymph node dissection (NVLND) in patients with gastric cancer after radical operation. Methods A total of 759 cases of evaluable patients with gastric cancer, operated from June 1994 to April 2005, were retrospectively analyzed. Of which, 627 cases underwent radical gastrectomy: 215 patients received VLND and 412 cases received NVLND. The operation time, intraoperative blood loss, operative complications and survival rate were recorded and compared between the two groups. Results The 5- and 10-year overall accumulative survival rates of VLND group and NVLND group were 55.4% and 51.2%, 39. 1% and 36. 8%, respectively (all P<0.05) . No significant differences in intraoperative blood transfusion (loss), operation time, operative complication rate was found between the two groups. The 5- and 10-year accumulative survival in patients with a tumor of phase N0-N2, T2-T4, Ib-Ⅳ in VLND groups were all significant higher than those in NVLND group. Conclusion VLND is a safe technique in advanced gastric cancer, it dose not prolong operation time or increase operative complications but improves survival.
