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目的探讨胃癌病人胰体尾侵犯的相关临床病理因素和手术干预的临床结局。方法回顾性分析1994年8月至2006年3月间中山大学附属第一医院胃癌数据库资料中病人的临床病理资料和随访结果。结果870例胃癌病人中有73例发生胰体尾侵犯。BorrmannⅣ型、肿瘤穿透浆膜、离胃>3cm淋巴结转移、腹膜扩散与胃癌胰体尾侵犯相关(P<0·05)。联合胰体尾切除根治术后,较严重的并发症发生率为2·3%(1/44),围手术期内无病人死亡。联合胰体尾切除根治术组病人1、3、5年存活率分别为63%、24%和19%,其1年内各时点存活率总体上高于胃癌姑息性切除组和姑息性手术组(P<0·05)。结论联合胰体尾切除的根治术具有可接受的手术并发症发生率,能显著改善胃癌胰体尾侵犯病人的近期预后。
Objective To investigate the clinical and pathological factors of pancreatic body and tail tail invasion in patients with gastric cancer and the clinical outcome of surgical intervention. Methods The clinical and pathological data and the follow-up results of patients in the database of gastric cancer of the First Affiliated Hospital of Sun Yat-sen University from August 1994 to March 2006 were retrospectively analyzed. Results Of the 870 patients with gastric cancer, 73 cases had pancreatic body and tail tail violations. Borrmann Ⅳ type, the tumor penetrating the serosa, lymph node metastasis from the stomach> 3 cm, the peritoneal spread was related to pancreatic body and tail tail invasion (P <0.05). Combined pancreatectomy radical resection, the more serious complication rate was 2.3% (1/44), no patient died during the perioperative period. The survival rates at 1, 3 and 5 years in patients treated with radical resection of pancreaticoduodenectomy were 63%, 24% and 19% respectively, and the survival rates at each time point in one year were generally higher than those in palliative resection and palliative surgery (P <0.05). Conclusions Radical resection of pancreatectomy with pancreaticoduodenectomy has an acceptable incidence of surgical complications and can significantly improve the short-term prognosis of patients with pancreatic body and tail tail invasion of gastric cancer.