Zhang X F, Lu H S, Yin F Z
Union Hospital of Fujian Medical College, Fuzhou.
Zhonghua Zhong Liu Za Zhi. 1994 Nov;16(6):447-50.
485 patients with adenocarcinoma of the gastric cardia operated in our hospital. 283 cases were treated with total gastrectomy, and 202 cases were treated with proximal subtotal gastrectomy. The age, sex, clinical stage, size of tumour, radicality of surgical resection, lymph node involvement, tumour depth penetration and histological type had no significant difference in the two groups. Analysis of survival rates failed to demonstrate any significant difference between the two types of surgical operation for TNM stage I and II. Total gastrectomy resulted in significantly higher survival rate than proximal subtotal gastrectomy for stage III. The 3- and 5-year survival rate of TNM stage III patients increased by 14.6% and 15.1%, respectively (P < 0.05). Extended total gastrectomy was usually applied for stage IV patients without distant metastasis. If the neoplasm had spread beyond the confines of extended total gastrectomy, in order to eliminate obstruction or bleeding, palliative proximal subtotal gastrectomy or total gastrectomy should be considered.
我院对485例贲门腺癌患者实施了手术。其中283例行全胃切除术，202例行近端胃次全切除术。两组患者在年龄、性别、临床分期、肿瘤大小、手术切除根治性、淋巴结受累情况、肿瘤浸润深度及组织学类型方面均无显著差异。对生存率的分析表明，对于TNM Ⅰ期和Ⅱ期患者，两种手术方式之间无显著差异。对于Ⅲ期患者，全胃切除术的生存率显著高于近端胃次全切除术。TNM Ⅲ期患者的3年和5年生存率分别提高了14.6%和15.1%（P<0.05）。对于无远处转移的Ⅳ期患者通常采用扩大全胃切除术。如果肿瘤已扩散至扩大全胃切除术范围之外，为消除梗阻或出血，应考虑行姑息性近端胃次全切除术或全胃切除术。
