摘要目的 比较全胃切除术与近侧胃大部切除术治疗贲门腺癌的疗效.方法 回顾性分析2011年7月至2013年7月信阳市中心医院收治的82例贲门腺癌患者的临床资料,将82例患者分为行全胃切除术的观察组和实施近侧胃大部切除的对照组.比较两组患者术后1、3年生存率及术后并发症的发生情况.结果 术后观察组39例患者达到Ⅰ～Ⅲ期,有效率为92.9％,显著优于对照组的80.0％,差异有统计学意义(P＜0.05);观察组死亡1例,同期对照组为4例;术后观察组1、3年生存率分别为83.3％和40.5％,明显高于对照组的52.5％和27.5％,差异有统计学意义(P＜0.05);观察组术后出现并发症11例(26.2％),少于同期对照组的15例(37.5％),差异有统计学意义(P＜0.05).结论 在手术切除贲门腺癌,特别是Ⅲ、Ⅳ期肿瘤方面,行全胃切除术患者较近侧胃大部切除患者术后生存期更长,并发症更少,整体效果也更为突出.不过建议临床根据患者病期、肿瘤大小等来选择全胃切除术或近侧胃大部切除术.

abstractsObjective To compare the effects of total gastrectomy and proximal subtotal gastrectomy on gastric cardia adenocarcinoma.Methods From July 2011 to July 2013,the clinical data of 82 patients with gastric cardia adenocarcinoma in Xinyang central hospital were retrospectively analyzed.The 82 patients were divided into observation group and control group,the patients in observation group were given total gastrectomy,and the patients in control group were given proximal subtotal gastrectomy.The 1-year and 3-year survival rate and incidence of postoperative complications were compared between the two groups.Results Thirty-nine patients in the observation group reached stage Ⅰ,Ⅱ and Ⅲ,the effective rate was 92.9％ in the observation group,which was significantly higher than that in the control group(80.0％),there was significant difference(P ＜0.05).In observation group,1 patient died,and 4 patients died in the control group.In observation group,the 1-year and 3-year survival rate was 83.3 ％ and 40.5％,which was significantly higher than that in the control group(52.5％ and 27.5％),there were significant differences(P ＜ 0.05).Eleven patients(26.2％) had postoperative complications in the observation group,which was less than that in the control group [15 cases(37.5％)],there was significant difference(P ＜ 0.05).Conclusions In terms of surgical resection cardia adenocarcinoma,especially stage Ⅲ and Ⅳ tumors,patients with total gastrectomy have longer survival rate,fewer complications,and better overall effect.However,the clinical recommendations should be based on the patient' s disease stage,tumor size to choose total gastrectomy or proximal subtotal gastrectomy.