摘要
作者对比观察不同病期和生物学行为胃癌的Ｒ２、Ｒ３手术疗效，探讨合理选择两种术式的适应证。结果表明：ＴＮＭⅠ期（Ⅰ３、Ⅰｂ、）Ｒ２、Ｒ３术后５年生存率基本相同，Ｒ２即可根治。Ⅱ、Ⅲａ期，Ｒ３优于Ｒ２。Ⅲｂ、Ⅳ期胃癌，Ｒ３仍比Ｒ２的５年生存率提高２５．５％。早期癌及ＢｏｒｒｍａｎｎⅠ、Ⅱ型者两组相似，Ｒ３对ＢｏｒｒｍａｎｎⅢ、Ⅳ型癌可提高根治的疗效。Ⅰａ、Ⅰｂ期的胃壁内癌，淋巴结转移限于第一站者，Ｒ２即可达到根治；Ⅱ期以上侵透浆膜者，Ｒ３手术辅助防治腹膜转移的措施仍可提高５年生存率。病理学的弥慢性生长方式、未分化癌及淋巴管癌栓者、生物学行为较差，对进行期病例，应选择Ｒ３扩大淋巴结清除术。
The authors investigated the operative effects of
R2,R3 lymphnode dissection and studied their oper-ative indication individually based on
different stage and biological behavior in 309 cases of gastric carci-noma. The 5 years survival
rate of R2 was nearly the same as R3 in patients at stage Ⅰ(Ⅰa,Ⅰb)andBorrmann typeⅠand
Ⅱ,while R3 yielded better results than R2 at stageⅡand Ⅲ a,it was even25.5%higher by R3
than by R2 at Ⅲ b and Ⅳ. R3 still benefits for the patients at over stageⅡwithserosa infiltrated
and Borrmann type Ⅲ and Ⅳ,R3 should also be performeo in advanced cases withpoorly
biological behavior,such as diffuse growth pattern;undifferentiated cancer and lymphatic
can-cerous embosis.
出处
《中国医科大学学报》
CAS
CSCD
1994年第6期578-581,共4页
Journal of China Medical University
