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目的 探讨全胃切除指征、手术切除范围及全胃切除术后消化道重建方式对生存质量的影响。方法 回顾性分析 84例全胃切除临床资料。结果 男性 5 5例 ,女性 2 9例。年龄 2 7～ 73岁。根治性全胃切除 73例 ,姑息性切除 11例。全组术后并发症 2 2例( 2 6 19% ) ,手术死亡 2例 ( 2 3 8% )。术后 1、3、5年生存率分别为 90 48% ( 76/ 84)、45 3 3 % ( 3 4 / 75 )、2 7 5 9% ( 16/ 5 8)。结论 :全胃切除术是治疗胃癌的一种重要、有效的术式 ,应根据患者的年龄、营养状况、病期合理掌握适应证及手术切除范围 ,消化道重建方式与术后并发症和术后生存质量有关 ,“P”型空肠代胃术后生存质量较好。术后辅助治疗可提高远期生存率。
Objective To investigate the indications of total gastrectomy, the scope of resection and the effect of digestive tract reconstruction after total gastrectomy on the quality of life. Methods Retrospective analysis of 84 cases of total gastrectomy clinical data. Results There were 55 males and 29 females. Age 27 ~ 73 years old. Radical total gastrectomy in 73 cases, palliative resection in 11 cases. The whole group of postoperative complications in 22 cases (26%), surgical death in 2 cases (23.8%). The 1, 3, 5-year survival rates were 90 48% (76/84), 45 3 3% (34/75) and 25 75% (16/58), respectively. Conclusion: Total gastrectomy is an important and effective surgical treatment of gastric cancer. It should be based on the patient’s age, nutritional status, disease duration and reasonable indications and surgical resection range, gastrointestinal reconstruction and postoperative complications and surgery After the quality of life, “P” type of jejunum on behalf of the stomach after the better quality of life. Postoperative adjuvant therapy can improve long-term survival.