摘要
目的 探讨保留幽门和迷走神经的胃部分切除手术（PPG）对早期胃癌的疗效.方法 回顾性分析1995年8月至2005年12月对52例早期胃癌患者行保留幽门和迷走神经的胃部分切除术（PPG组）的临床资料和随访结果;并与同期行远端胃切除术伴淋巴结清除的159例早期胃癌患者（对照组）的临床资料进行比较.结果 PPG组早期胃癌的淋巴结转移率为9.6%,对照组淋巴结转移率为17.0%;两组比较,差异无统计学意义（P＞0.05）.PPG组淋巴结清除范围D1为25%,D1＋α（α=No.7）为25%,D1＋β（β=No.8a和No.9）为34.6%,D2为15.3%;对照组121例（76.1%）D2以下,33例（20.7%）D2,5例（3.1%）D3;两组比较,差异无统计学意义（P＞0.05）.术后累计5年生存率PPG组为92.3%,对照组93.1%,两组差异无统计学意义（P=0.881）.其中淋巴结不同清除程度的累计5年生存率PPG组：D1为100%,D1＋α为92.3%,D1＋β为88.9%,D2为87.5%;对照组：D1为92.3%,D1＋α为93.3%,D1＋β为91.7%,D2为93.9%;两组比较,差异无统计学意义（P＞0.05）.PPG组术后的复发率为5.7%,对照组则为5.6%,两组差异无统计学意义（P＞0.05）.结论 PPG对于早期胃癌的治疗是有效的.
Objective To evaluate the outcomes after pylorus-preserving gastrectomy （PPG） for early gastric cancer （EGC）. Methods Clinicopathologic data of 52 patients with EGC undergoing PPG between August 1995 and December 2005 were analyzed retrospectively. A total of 159 patients of EGC who underwent distal gastrectomy with lymph node dissection （control group） were compared with those who received PPG. Results The lymph node metastasis rate of EGC was 9.6% in PPG group,including 9.6% in No.3, 3.9% in No.4, 3.9% in No.6, and 3.9% in No.7. In the control group, the lymph node metastasis rate was 17.0%, including N1（14.5%） and N2（2.5%）. There were no significant differences between the PPG group and the control group （P〉0.05）. In the PPG group, D1 dissection was 25%, D1＋α was 25%, D1＋β was 34.6%, and D2 was 15.3%. In control group, 121 patients （76.1%） had less than D2 dissection, while there were 33（20.7%） D2, and 5（3.1%） D3, and the difference was not statistically significant （P〉0.05）. There were no significant differences between the two groups in overall 5-year survival rate（92.3% vs. 93.1%, P=0.881 ）. The 5-year survival rate in the PPG group was 100% for D1, 92.3% for D1＋α, 88.9% for D1＋β , and 85.7% for D2, while the 5-year survival rate in the control group was 92.3% for D1, 93.3% for D1＋α, 91.7% for D1＋β, and93.9% for D2. The difference was not statistically significant （P〉0.05）. The recurrence rate was comparable （5.7% vs. 5.6%, P〉0.05）. Conclusion Pylorus-preserving gastrectomy may provide longterm survival benefits for patients with early gastric cancer.
出处
《中华胃肠外科杂志》
CAS
北大核心
2010年第12期907-909,共3页
Chinese Journal of Gastrointestinal Surgery
