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目的对早期胃癌的不同手术方式及其临床治疗结果进行总结与分析,希望以此为提高早期胃癌的手术安全性和临床治疗效果提供理论依据。方法远端胃次全切除术49例,近端胃大部切除7例,全胃切除术2例。术中同时行淋巴结清扫术(ELND),D1+术13例,D2术29例以及D2+术16例。结果 58例早期胃癌患者均较顺利完成全部手术,未发生术中死亡的病例。术后发生相关并发症的8例,其中发生切口感染者居多为5例,均不属于严重并发症,经治疗后3~7 d痊愈。结论早期胃癌手术方式的选择,主要取决于术前准确的诊断结论和术中探查的淋巴结转移情况,过分强调缩小手术则有可能增加术后癌症复发的几率,癌症病灶和淋巴结能否彻底清除是早期胃癌手术成功与否的关键。
Objective To summarize and analyze the different operation methods and clinical treatment results of early gastric cancer and hope to provide a theoretical basis for improving the operative safety and clinical effect of early gastric cancer. Methods 49 cases of distal gastrectomy, proximal gastrectomy in 7 cases, total gastrectomy in 2 cases. In operation, lymph node dissection (ELND) was performed simultaneously, 13 cases of D1 +, 29 cases of D2 and 16 cases of D2 +. Results All the 58 cases of early gastric cancer were successfully completed the operation without any intraoperative deaths. Postoperative complications occurred in 8 cases, of which incision infection were mostly in 5 cases, are not serious complications, 3 to 7 days after treatment healed. Conclusion The choice of operative method for early gastric cancer mainly depends on the accurate preoperative diagnosis and lymph node metastases detected during operation. Overemphasis on shrinkage surgery may increase the probability of postoperative cancer recurrence, and whether the complete removal of cancer lesions and lymph nodes is The key to success of early gastric cancer surgery.