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目的评价进展期胃癌根治手术的优势与不足,分析手术方式的合理选择。方法回顾2002年4月至2010年3月于我院进行进展期胃癌扩大手术患者的手术资料与术后生活情况,将其分为两组,根治手术组42例,手术方式为联合脏器切除和扩大淋巴结清扫,姑息性手术组21例,采用仅切除原发病灶,尚有部分残余的切除手术,通过对两组患者的手术资料、生存情况与生活质量评价进展期胃癌扩大根治手术的合理选择和疗效。结果姑息性手术组在术后1年、3年、5年内的生存数量分别为9人、2人、0人;根治手术组患者在1年、3年、5年内的生存数量分别为29人、13人、6人。结论进展期胃癌扩大根治性手术效果要明显好于姑息性手术,是当前较为理想的选择,但选择手术方式时仍需考虑患者的身体情况,如患者身体无法承担大型手术,则采取姑息性手术尽量延长患者存活时间是较好的选择。
Objective To evaluate the advantages and disadvantages of radical operation for advanced gastric cancer and to analyze the reasonable choice of surgical approach. Methods From April 2002 to March 2010 in our hospital for advanced gastric cancer surgery patients with surgical data and postoperative living conditions, divided into two groups, radical surgery group of 42 patients, the surgical approach for the removal of organs And expand the lymph node dissection, palliative surgery group of 21 cases, only the removal of the primary lesion, there are still some residual resection surgery, surgery data on two groups of patients, survival and quality of life assessment of advanced gastric cancer to expand the radical surgery is reasonable Choice and efficacy. Results The numbers of survivors in palliative surgery group were 9, 2 and 0 respectively after 1 year, 3 years and 5 years after operation. Survival numbers of patients in radical surgery group at 1 year, 3 years and 5 years were 29 , 13 people, 6 people. Conclusion The effect of extended radical surgery in advanced gastric cancer is better than that of palliative surgery, which is an ideal choice at present. However, it is still necessary to consider the patient’s physical condition when choosing the surgical method. If the patient can not afford the large-scale operation, palliative surgery Try to extend the patient’s survival time is a better choice.