He Beibei, Li Shengwen, Guo Yaming, Li Song, Zhu Wenjun, Wang Xinyi, Chen Baozhang, Wu Shile
Department of General Surgery, Qinghai Provincial People's Hospital, Xining City, Qinghai Province, China.
Medicine (Baltimore). 2025 Aug 29;104(35):e44020. doi: 10.1097/MD.0000000000044020.
This study analyzes the application value of extended multi-organ resection in the treatment of locally advanced gastric cancer, and to provide reference for the clinical diagnosis and treatment of locally advanced gastric cancer patients. From January 2016 to April 2022, 64 cases of locally advanced gastric cancer admitted to our hospital were analyzed retrospectively. Combined multiple organ resection was used as the treatment strategy, and the general information and surgical data of patients were analyzed to evaluate the prognosis of extended multi-organ resection in the treatment of locally advanced gastric cancer and the factors affecting these clinical outcomes. A total of 64 patients with locally advanced gastric cancer were included, including 34 males and 30 females, with an average age of 57.28 ± 12.27 years. Among them, combined pancreatectomy was performed in 25 cases, splenectomy in 20 cases, hepatectomy in 12 cases, pancreaticoduodenectomy in 5 cases, pancreaticoduodenectomy and right colon resection in 1 case, and colon resection in 1 case. The average operation time was 159.64 ± 25.19 minutes and the median intraoperative bleeding was 150 mL. All 64 patients achieved R0 resection, and all patients were followed up. Postoperative complications occurred in 18 cases, of which the mortality rate was 16.67% (3/18). The 1-year, 3-year, and 5-year survival rates were 59.4%, 35.9%, and 14.6%, respectively. It is feasible to treat locally advanced gastric cancer by extended combined organ resection. As long as the indications are strictly grasped, the overall prognosis of patients can be improved.
本研究分析扩大多器官切除术在局部进展期胃癌治疗中的应用价值，为局部进展期胃癌患者的临床诊治提供参考。回顾性分析2016年1月至2022年4月我院收治的64例局部进展期胃癌患者。采用联合多器官切除术作为治疗策略，分析患者的一般资料和手术数据，以评估扩大多器官切除术治疗局部进展期胃癌的预后及影响这些临床结局的因素。共纳入64例局部进展期胃癌患者，其中男性34例，女性30例，平均年龄57.28±12.27岁。其中，25例行联合胰切除术，20例行脾切除术，12例行肝切除术，5例行胰十二指肠切除术，1例行胰十二指肠切除术联合右半结肠切除术，1例行结肠切除术。平均手术时间为159.64±25.19分钟，术中中位出血量为150 mL。64例患者均实现R0切除，所有患者均获随访。术后并发症发生18例，其中死亡率为16.67%（3/18）。1年、3年和5年生存率分别为59.4%、35.9%和14.6%。采用扩大联合器官切除术治疗局部进展期胃癌是可行的。只要严格掌握适应证，就能改善患者的总体预后。
