中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
14期
1096-1099
,共4页
胡俊峰%邵钦树%孙元水%许晓东%徐继
鬍俊峰%邵欽樹%孫元水%許曉東%徐繼
호준봉%소흠수%손원수%허효동%서계
早期胃癌%胃切除术%迷走神经%幽门
早期胃癌%胃切除術%迷走神經%幽門
조기위암%위절제술%미주신경%유문
Early gastric cancer%Gastrectomy%Vagus nerve%Pylorus
目的 探讨保留迷走神经、幽门胃部分切除手术在胃体早期癌的远期效果.方法 回顾性分析了2004年1月至2009年6月在我院普外科收治的131例早期胃体癌患者,分别行PPG手术46例,DG手术85例,比较分析两组远期的主观、客观指标,以及术后2年胃镜检查结果和5年肿瘤复发及患者生存情况,评价PPG手术的效果.结果 DG组术后倾倒综合征发生率(8.2％)高于PPG组(0),术后18个月DG组胆囊结石发生率高于PPG组,均P＜0.05,差异有统计学意义.术后DG组患者返流症状发生率高,而食物淤滞症状发生率低,两组差异均无统计学意义.PPG组患者术后体重、血浆白蛋白、血胆固醇等指标恢复较DG组好,但差异无统计学意义.术后2年胃镜检查发现PPG组食物潴留(31.1％) (14/45)明显高于DG组(10.8％) (9/83),P＜0.05,差异有统计学意义.术后5年肿瘤复发率:PPG组术后复发率为6.5％ (3/46),DG组为8.2％ (7/85),两组比较P=0.724,差异无统计学意义;PPG组的累积5年生存率为91.3％与DG组90.6％之间差异无统计学意义.结论 PPG手术对于改善胃体早癌的预后、提高胃癌患者术后生活质量具有重要的意义.
目的 探討保留迷走神經、幽門胃部分切除手術在胃體早期癌的遠期效果.方法 迴顧性分析瞭2004年1月至2009年6月在我院普外科收治的131例早期胃體癌患者,分彆行PPG手術46例,DG手術85例,比較分析兩組遠期的主觀、客觀指標,以及術後2年胃鏡檢查結果和5年腫瘤複髮及患者生存情況,評價PPG手術的效果.結果 DG組術後傾倒綜閤徵髮生率(8.2％)高于PPG組(0),術後18箇月DG組膽囊結石髮生率高于PPG組,均P＜0.05,差異有統計學意義.術後DG組患者返流癥狀髮生率高,而食物淤滯癥狀髮生率低,兩組差異均無統計學意義.PPG組患者術後體重、血漿白蛋白、血膽固醇等指標恢複較DG組好,但差異無統計學意義.術後2年胃鏡檢查髮現PPG組食物潴留(31.1％) (14/45)明顯高于DG組(10.8％) (9/83),P＜0.05,差異有統計學意義.術後5年腫瘤複髮率:PPG組術後複髮率為6.5％ (3/46),DG組為8.2％ (7/85),兩組比較P=0.724,差異無統計學意義;PPG組的纍積5年生存率為91.3％與DG組90.6％之間差異無統計學意義.結論 PPG手術對于改善胃體早癌的預後、提高胃癌患者術後生活質量具有重要的意義.
목적 탐토보류미주신경、유문위부분절제수술재위체조기암적원기효과.방법 회고성분석료2004년1월지2009년6월재아원보외과수치적131례조기위체암환자,분별행PPG수술46례,DG수술85례,비교분석량조원기적주관、객관지표,이급술후2년위경검사결과화5년종류복발급환자생존정황,평개PPG수술적효과.결과 DG조술후경도종합정발생솔(8.2％)고우PPG조(0),술후18개월DG조담낭결석발생솔고우PPG조,균P＜0.05,차이유통계학의의.술후DG조환자반류증상발생솔고,이식물어체증상발생솔저,량조차이균무통계학의의.PPG조환자술후체중、혈장백단백、혈담고순등지표회복교DG조호,단차이무통계학의의.술후2년위경검사발현PPG조식물저류(31.1％) (14/45)명현고우DG조(10.8％) (9/83),P＜0.05,차이유통계학의의.술후5년종류복발솔:PPG조술후복발솔위6.5％ (3/46),DG조위8.2％ (7/85),량조비교P=0.724,차이무통계학의의;PPG조적루적5년생존솔위91.3％여DG조90.6％지간차이무통계학의의.결론 PPG수술대우개선위체조암적예후、제고위암환자술후생활질량구유중요적의의.
Objective To evaluate the long-term outcomes of pylorus-vagus-preserving partial gastrectomy for early gastric cancer in middle third of stomach.Methods Between January 2004 and June 2009,46 patients with early gastric cancer in middle third of stomach underwent pylorus-vagus-preserving partial gastrectomy (PPG) while another 85 patients had conventional distal gastrectomy (DG).Clinicopathologic data and follow-up results of two groups were analyzed retrospectively,including the results of subjective nutritional assessments,laboratory blood biochemical data,endoscopic findings of remnant stomach and total 5-year survival rates.Results Postprandial dumping syndrome occurred in 7 patients (8.2％) in DG group while no syndrome occurred in PPG group.The incidence of gallbladder stones at 18 months after operation in DG group was higher than that in PPG group.Significant difference existed between two groups (P ＜ 0.05).Even though no significant difference existed in laboratory blood biochemical data and endoscopic findings,PPG group recovered better and regurgitation was frequently found in DG group.Food residue in gastric remnant was frequently observed in PPG (31.1％) than in DG (10.8％,P ＜ 0.05) by endoscopic findings At 2 years post-operation,the postoperative 5-year recurrence rate was 6.5 ％ (2/46) in PPG group versus 8.2％ (7/85) in DG group.However no significant difference existed between 2 groups (P =0.724).No significant difference existed between PPG group (91.3％) and DG group (90.6％) in overall 5-year survival rate.Conclusion For early gastric cancer in middle third of stomach,pylorus-vagus-preserving partial gastrectomy is effective in maintaining postoperative function.And it has the same postoperative survival rate as conventional distal gastrectomy.
