摘要
目的比较血管鞘内、外淋巴结清扫对胃癌患者临床结局的影响。方法回顾性分析1994年6月至2005年4月外科治疗的759例胃癌患者的临床资料，其中根治性切除627例，并分别采取血管鞘内淋巴结清扫（VLND组，215例）和血管鞘外淋巴结清扫（NVLND组，412例）。分析比较两组不同的淋巴结清扫方法的手术时间、术中失血量、外科并发症等资料，并比较分析两组术后生存率差异。结果根治性切除手术后5年和10年生存率比较：VLND组分别为55．4％和51．2％，NVLND组分别为39．1％和36．8％，两组差异均有统计学意义（P〈0．05）。VLND组中N0—N2、T2-T4、Ⅰb～Ⅳ期胃癌患者术后5、10年累积生存率均显著高于NVLND组。而术中输血量、手术时间、手术并发症、术后并发症两组差异无统计学意义。结论对于进展期胃癌患者，血管鞘内淋巴结清扫可提高术后生存率，不增加手术时间和术后并发症，是安全的淋巴结清扫技术。
Objective To evaluate and compare the results of vagina vasorum lymph node dissection （VLND） and non-vagina vasorum lymph node dissection （NVLND） in patients with gastric cancer after radical operation. Methods A total of 759 cases of evaluable patients with gastric cancer, operated from June 1994 to April 2005, were retrospectively analyzed. Of which, 627 cases underwent radical gastrectomy： 215 patients received VLND and 412 cases received NVLND. The operation time, intraoperative blood loss, operative complications and survival rate were recorded and compared between the two groups. Results The 5- and 10-year overall accumulative survival rates of VLND group and NVLND group were 55.4% and 51.2%, 39. 1% and 36. 8% , respectively （ all P 〈 0. 05） . No significant differences in intraoperative blood transfusion （loss） , operation time, operative complication rate was found between the two groups. The 5- and 10-year accumulative survival in patients with a tumor of phase N0-N2, T2-T4, Ⅰ b-Ⅳ in VLND groups were all significant higher than those in NVLND group. Conclusion VLND is a safe technique in advanced gastric cancer, it dose not prolong operation time or increase operative complications but improves survival.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2009年第9期673-676,共4页
Chinese Journal of Surgery
关键词
胃肿瘤
淋巴结切除术
预后
Stomach neoplasms
Lymph node excision
Prognosis
