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[胃癌手术的发病率和死亡率——468例胃腺癌病例分析]

[Morbidity and mortality in gastric cancer surgery--analysis of 468 cases with gastric adenocarcinoma].

作者信息

Necula A, Vlad L, Iancu C, Munteanu D, Puia C, Bălă O, AlHajaar N, Pop F, Radu H, Osian G, Graur F, Furcea Luminiţa, Stanca M, Molnar G, Mocanu L

机构信息

Clinica Chirurgie III, UMF Iuliu Haţieganu Cluj, Napoca.

出版信息

Chirurgia (Bucur). 2008 Sep-Oct;103(5):529-37.

Abstract

The aim of this study is to evaluate the morbidity and mortality in the surgical treatment of gastric cancer and the factors that could influencing them. We made a retrospective analysis of a group of 468 patients with gastric adenocarcinoma which have been operated in the 3RD Surgical Clinic-Cluj Napoca--01.01.1998-31.12.2003. We analyzed parameters related to patient, pTNM stage and type of treatment. Morbidity was significantly higher in these circumstances: elder patients, cases with lower serum levels of hemoglobin and total proteins, after Billroth II procedures; we found no significant differences of morbidity depending on gender, pTNM stage, type of intervention: simple or multiorgan resection, subtotal or total gastrectomy, radical or palliative procedure or only exploratory laparotomy, presence or absence of splenectomy or caudal pancreatectomy, D1 or D2 lymphadenectomy (in radical procedures), palliative resection or gastrojejunal bypass. Elder patients and male patients have had a mortality significantly higher; we found no significant differences of mortality depending on serum levels of hemoglobin and total proteins, pTNM stage, type of intervention: simple or multiorgan resection, subtotal or total gastrectomy, radical or palliative procedure or only exploratory laparotomy, presence or absence of splenectomy or caudal pancreatectomy, D1 or D2 lymphadenectomy (in radical procedures), type of restoring of the digestive continuity after subtotal gastrectomy, palliative resection or gastrojejunal bypass.

摘要

本研究的目的是评估胃癌手术治疗中的发病率和死亡率以及可能影响它们的因素。我们对1998年1月1日至2003年12月31日在克卢日-纳波卡第三外科诊所接受手术的468例胃腺癌患者进行了回顾性分析。我们分析了与患者、pTNM分期和治疗类型相关的参数。在以下情况下发病率显著更高:老年患者、血红蛋白和总蛋白血清水平较低的病例、毕罗Ⅱ式手术后;我们发现发病率在性别、pTNM分期、干预类型(单纯或多器官切除、次全或全胃切除、根治性或姑息性手术或仅探查性剖腹术)、是否行脾切除术或胰尾切除术、D1或D2淋巴结清扫术(在根治性手术中)、姑息性切除或胃肠吻合术方面无显著差异。老年患者和男性患者的死亡率显著更高;我们发现死亡率在血红蛋白和总蛋白血清水平、pTNM分期、干预类型(单纯或多器官切除、次全或全胃切除、根治性或姑息性手术或仅探查性剖腹术)、是否行脾切除术或胰尾切除术、D1或D2淋巴结清扫术(在根治性手术中)、次全胃切除术后消化连续性恢复类型、姑息性切除或胃肠吻合术方面无显著差异。

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