CAJ | 학술논문

目的：探讨近端胃癌术后消化道重建的理想术式。方法选取2012年5月—2014年1月哈尔滨医科大学附属肿瘤医院收治的近端胃癌111例，按手术方法分为改良组（食管－管状胃吻合）和传统组（食管－残胃吻合），追踪随访术后并发症的发生率并对患者术后的生活质量应用欧洲癌症研究与治疗组织（ EORTC）制定的QLQ－C30量表及QLQ－STO22量表进行统计学分析。结果两组患者术后随访期内均未出现死亡病例，两组患者在手术时间、术中出血量及术后一个月的体重变化上无统计学意义，在术后六个月体重变化上有统计学意义，改良组要优于传统组。在对EORTC QLQ－C30量表和QLQ －STO22量表进行分析后，在恶心呕吐、吞咽困难、疼痛及返流方面具有统计学意义，改良组优于传统组，其余无统计学意义。结论相比传统组，改良组可以有效减少术后恶心呕吐、吞咽困难、疼痛和返流等并发症的发生率，能有效改善术后患者的生活质量，可作为近端胃切除后消化道重建的提倡术式。
목적：탐토근단위암술후소화도중건적이상술식。방법선취2012년5월—2014년1월합이빈의과대학부속종류의원수치적근단위암111례，안수술방법분위개량조（식관－관상위문합）화전통조（식관－잔위문합），추종수방술후병발증적발생솔병대환자술후적생활질량응용구주암증연구여치료조직（ EORTC）제정적QLQ－C30량표급QLQ－STO22량표진행통계학분석。결과량조환자술후수방기내균미출현사망병례，량조환자재수술시간、술중출혈량급술후일개월적체중변화상무통계학의의，재술후륙개월체중변화상유통계학의의，개량조요우우전통조。재대EORTC QLQ－C30량표화QLQ －STO22량표진행분석후，재악심구토、탄인곤난、동통급반류방면구유통계학의의，개량조우우전통조，기여무통계학의의。결론상비전통조，개량조가이유효감소술후악심구토、탄인곤난、동통화반류등병발증적발생솔，능유효개선술후환자적생활질량，가작위근단위절제후소화도중건적제창술식。
Objective To explore the improvement of the digestive tract reconstruction surgery of post-operative proximal gastric cancer .Methods One hundred and eleven patients were chosen in our hospital from May 2012 to January 2014 ,and were divided into modified group ( gastric tube-esophageal anastomosis ) and tra-ditional group ( remnant stomach-esophageal anastomosis ) .Following -up visits were carried out for the inci-dence of postoperative/complications ,and the postoperative quality of life was analyzed with EORTC QLQ -C30 and QLQ-STO22.Results There was no death case in both groups in the postoperative following -up period. The duration of operation , amount of bleeding during operation and weight changes after a month of the both groups were no statistical significance .However ,there was statistical significance in weight changes after operation 6 months,and the results of modified group was better than traditional group .By analyzing the EORTC QLQ-C30 and QLQ-STO22,there was statistical significance in nausea and vomiting ,dysphagia,pain,reflux,and the re-sults of modified group was better than traditional group ,there were no statistical significances of others .Conclu-sion Compared with the traditional group ,modified group can decrease postoperative nausea and vomiting ,dys-phagia,pain,reflux and improve the patients′postoperative quality of life effectively .It is recommended for diges-tive tract reconstruction after proximal gastrectomy excision .