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目的:探讨胃癌外科治疗的现状。方法:对我院2003年5月～2008年5月收治并手术治疗的胃癌440例的临床资料进行回顾性分析。结果:440例胃癌中,手术切除404例(91.82%),其中根治性切除364例,姑息性切除40例;远侧胃切除312例(77.23%),近侧胃切除28例(6.93%),全胃切除64例(15.84%);行消化道重建的416例中,手法吻合40例(9.62%),双吻合器吻合376例(90.38%)。术后病理早期癌36例(8.18%),进展期胃癌共404例(91.82%)。术前肠外营养支持5～7天56例(12.73%),术后行肠内营养344例(85.15%),肠外营养360例(89.11%)。手术死亡1例(0.23%),40例发生术后近期并发症(9.09%)。结论:胃癌患者早期诊断仍困难,但手术切除率及根治性切除率较以前明显升高,吻合器使用明显增加,有助于降低近期并发症发生率并提高肿瘤治疗的效果。需长期营养支持时肠内营养较肠外营养更容易维持内环境稳定。
Objective: To investigate the status of surgical treatment of gastric cancer. Methods: The clinical data of 440 cases of gastric cancer admitted to our hospital from May 2003 to May 2008 were retrospectively analyzed. Results: Of the 440 gastric cancers, 404 (91.82%) were resected surgically, including 364 cases of radical resection and 40 cases of palliative resection. There were 312 cases of distal gastrectomy (77.23%) and 28 cases of proximal gastrectomy (6.93% , Total gastrectomy in 64 cases (15.84%); in 416 cases of gastrointestinal reconstruction, 40 cases (9.62%) were anastomosed by hand and 376 cases (90.38%) by double stapler. There were 36 cases (8.18%) of early postoperative pathology and 404 cases (91.82%) of advanced gastric cancer. Preoperative parenteral nutrition support 56 cases (12.73%) 5-7 days, 344 cases of enteral nutrition (85.15%), 360 cases of parenteral nutrition (89.11%). One case died of surgery (0.23%), and the other 40 cases had immediate postoperative complications (9.09%). Conclusion: The early diagnosis of gastric cancer patients is still difficult, but the resection rate and radical resection rate was significantly higher than before, the use of staplers increased significantly, which will help to reduce the incidence of recent complications and improve the efficacy of cancer treatment. When long-term nutritional support is required, enteral nutrition is more likely to maintain stable internal environment than parenteral nutrition.