CAJ | 학술논문

目的：比较近端胃切除和全胃切除对术后辅助化疗耐受性及完成率的影响。方法：回顾性分析142例胃上部癌病例不同术式对术后化疗的影响，观察严重不良反应的发生率、导致化疗终止的原因及内镜下反流性食管炎发病率及吻合口病变。结果：85例行近端胃切除，57例行全胃切除，术后化疗的完成率两组分别为21．2％和54．4％；化疗严重不良反应发生率近端胃切除组为48．2％，高于全胃切除组；导致化疗不耐受的原因中，近端胃切除组消化道不良反应所占比例为43．3％，尤其是呕吐反应的发生率达到35．8％，明显高于全胃切除组；近端胃切除组反流性食管炎及吻合口溃疡的发生率亦明显高于全胃切除组，差异均具有统计学意义。结论：近端胃切除组病例术后化疗不良反应发生率高，化疗完成率低，这一术式是否合理有待商榷及进一步研究。
목적：비교근단위절제화전위절제대술후보조화료내수성급완성솔적영향。방법：회고성분석142례위상부암병례불동술식대술후화료적영향，관찰엄중불량반응적발생솔、도치화료종지적원인급내경하반류성식관염발병솔급문합구병변。결과：85례행근단위절제，57례행전위절제，술후화료적완성솔량조분별위21．2％화54．4％；화료엄중불량반응발생솔근단위절제조위48．2％，고우전위절제조；도치화료불내수적원인중，근단위절제조소화도불량반응소점비례위43．3％，우기시구토반응적발생솔체도35．8％，명현고우전위절제조；근단위절제조반류성식관염급문합구궤양적발생솔역명현고우전위절제조，차이균구유통계학의의。결론：근단위절제조병례술후화료불량반응발생솔고，화료완성솔저，저일술식시부합리유대상각급진일보연구。
Objective:To examine the difference of the effcts of two different surgical methods for proximal gastric cancer on adjuvant chemotherapy tolerance and completion rates .Methods: Retrospectively research the influence of two different surgical methods for 142 patients of proximal gastric cancer on postoperative chemotherapy ,observe the incidence of serious adverse effects , the cause of the termination of chemotherapy , the incidence of reflux esophagitis and the anastomotic lesions by endoscopic observation .Results: 142 patients with proximal gastric cancer was divied into 57 cases of total gastrectomy group and 85 cases of proximal gastrectomy group .The completion rates of postoperative chemotherapy of the two groups were respectively 21.2% and 54.4%,and the incidence of serious adverse reaction of proximal gastrectomy group was 48 .2% which was much higher than total gastrectomy group.Gastrointestinal adverse reactions rate was accounted for 43.3%in proximal gastrectomy group , especially the vomiting reaction rate which was higher reached 35 .8% among all the causes of chemotherapy intolerance .The incidence reflux esophagitis and anastomotic ulcer in proximal gastrectomy group was also higher than total gastrectomy group , and all the difference had statistical significance .Conclusion:Proximal gastrectomy group get higher incidence of postoperative chemotherapy side effects but lower chemotherapy completion rate , so whether it is reasonable of this surgical methods need further research .