肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2009年
2期
95-97
,共3页
胃肿瘤%胃切除术%淋巴结切除术%手术后并发症%死亡率
胃腫瘤%胃切除術%淋巴結切除術%手術後併髮癥%死亡率
위종류%위절제술%림파결절제술%수술후병발증%사망솔
Stomach neoplasms%Gastrectomy%Lymph node excision%Postoperative complications%Mortality
目的 分析实施D1和D2式胃癌切除术后患者的早期并发症发生率和死亡率,进一步提高胃癌手术治疗的效果.方法 收集2006年1月至2007年12月连续收治的实施D1或D2式胃癌切除术患者的临床资料,分析肿瘤临床病理特征、淋巴结廓清程度和术后早期并发症以及死亡率之间的关系.结果 130例患者实施了胃癌切除术,D1式34例,D2式96例.D2式术后早期并发症发生率明显高于D1式(20.6%比39.6%,P<0.05).进一步分析单个并发症的发生情况,两种术式差异无统计学意义.D2式术后死亡率为4.2%(4/96),D1式为0(0/34),但差异无统计学意义(P>0.05).死亡患者4例,均为D2式切除术.与吻合口瘘、胰瘘等相关的肺部并发症是术后患者死亡的重要原因.结论 D2式胃癌切除术是治疗胃癌安全有效的方法.淋巴结清除程度是增加术后并发症发生率和死亡率的因素.提高手术廓清技能和标准化胃癌淋巴结廓清术可能是减少术后早期并发症和死亡率的关键途径.
目的 分析實施D1和D2式胃癌切除術後患者的早期併髮癥髮生率和死亡率,進一步提高胃癌手術治療的效果.方法 收集2006年1月至2007年12月連續收治的實施D1或D2式胃癌切除術患者的臨床資料,分析腫瘤臨床病理特徵、淋巴結廓清程度和術後早期併髮癥以及死亡率之間的關繫.結果 130例患者實施瞭胃癌切除術,D1式34例,D2式96例.D2式術後早期併髮癥髮生率明顯高于D1式(20.6%比39.6%,P<0.05).進一步分析單箇併髮癥的髮生情況,兩種術式差異無統計學意義.D2式術後死亡率為4.2%(4/96),D1式為0(0/34),但差異無統計學意義(P>0.05).死亡患者4例,均為D2式切除術.與吻閤口瘺、胰瘺等相關的肺部併髮癥是術後患者死亡的重要原因.結論 D2式胃癌切除術是治療胃癌安全有效的方法.淋巴結清除程度是增加術後併髮癥髮生率和死亡率的因素.提高手術廓清技能和標準化胃癌淋巴結廓清術可能是減少術後早期併髮癥和死亡率的關鍵途徑.
목적 분석실시D1화D2식위암절제술후환자적조기병발증발생솔화사망솔,진일보제고위암수술치료적효과.방법 수집2006년1월지2007년12월련속수치적실시D1혹D2식위암절제술환자적림상자료,분석종류림상병리특정、림파결곽청정도화술후조기병발증이급사망솔지간적관계.결과 130례환자실시료위암절제술,D1식34례,D2식96례.D2식술후조기병발증발생솔명현고우D1식(20.6%비39.6%,P<0.05).진일보분석단개병발증적발생정황,량충술식차이무통계학의의.D2식술후사망솔위4.2%(4/96),D1식위0(0/34),단차이무통계학의의(P>0.05).사망환자4례,균위D2식절제술.여문합구루、이루등상관적폐부병발증시술후환자사망적중요원인.결론 D2식위암절제술시치료위암안전유효적방법.림파결청제정도시증가술후병발증발생솔화사망솔적인소.제고수술곽청기능화표준화위암림파결곽청술가능시감소술후조기병발증화사망솔적관건도경.
Objective To analyze the early mortality and morbidity of early postoperative complications of gastric cancer patients submitted to D1 or D2 gastrectomy for improving the surgical effect.Methods All consecutive patients who underwent D1 or D2 radical gastric resection between January 2006 and December 2007 were evaluated.Clinicopathologic features of the tumor,the extent of lymphadenectomy,the postoperative mortality and the early morbidity of complication were analysed.Results There were 130 patients admitted for the treatment of gastric cancer.34 underwent D1 dissection and 96 underwent D2 dissection.The early morbidity of D2 dissection was higher than that of D1 dissection (20.6% vs.39.6%,P<0.05).When complications were analyzed individually,there was no significant difference.Although the postoperative mortality was higher in the D2 group,no significant difference was observed(4.2% vs.0,P>0.05).4 patients underwent D2 dissection died.Considering the causes of the 4 died patients,respiratory complication related to anaatomotic and pancreatic leakage was the most important.Conclusion This study indicates that D2 dissection is a safe and effective procedure and the extent of lymphadenectomy may be related with high postoperative complication morbidity and mortality.Improving the surgical dissection skill and standardizing the gastric lymphadenectomy are the key ways to decrease the morbidity and mortality.
