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进展期胃癌D4术式和D2术式的临床比较
http://www.100md.com 《中国胃肠外科杂志》 1999年第3期
胃癌|淋巴廓清术|并发症,进展期胃癌D4术式和D2术式的临床比较,Abstract,Keywords
     /doctitle>姜波健 吴涛 高友福 孙荣勋 王宏强 涂长龄 200040 上海,上海市静安区中心医院普通外科 中国胃肠外科杂志 1999 0 2 3 胃癌;淋巴廓清术;并发症 胃肠外科学 期刊 zgwcwkzz 0 论著 fur

    


    

摘要 目的 探讨D4 术临床应用的可行性、合理性及安全性,并与D2 廓清术相比较。方法 进展期胃癌分别行D2 术(29例)和D4 术(22例),比较两组病例的手术根治度和围手术期指标。结果 D4 术较D2 术的治愈性根治或非治愈性根治切除比例有明显提高(81.8% vs. 55.2%;P<0.05)。同时,D4 术会导致平均引流天数的延长[(16±2)日 vs. (10±1)日,P<0.01]及引流率和引流量的增加,此外平均手术用血[(803±112) mL/例 vs. (566±67) mL/例, P<0.05]和平均手术时间[(7.5±0.3) h vs. (4.0±0.2) h, P<0.05]亦有明显增加,但手术死亡率、并发症发生率及住院时间等未有明显增加。结论 D4 术是安全、合理和可行的,宜在继续探索的基础上,在适宜病例中予以推广。

Comparison of resectability and paraoperative data of D4 and D2 lymphadenectomy in advanced gastric cancer

JIANG Bojian, WU Tao, GAO Youfu, et al. Department of General Surgery, Shanghai Jing'an Central Hospital, Shanghai 200040

Abstract Objective To study the safety, feasibility and reasonability of D4 lymphadenectomy compared with D2 approach. Methods D4 (n=22) or D2 lymphadenectomy (n=29) was carried out in advanced gastric cancer (AGC) cases. The resectability, mortality, complicative incidence, volume of transfused blood, hospitalized days and medical and so on were compared and analyzed retrospectively in this study. Results The ratio of the curable resection in the cases of D4 lymphadenectomy was significantly higher than that in the cases of D2 operation(81.8% vs. 55.2%,P<0.05). At the same time, D4 resection would result in the prolongation of drainage days, increasing of drainage rate and drainage amount. On the other hand, the amount of transfused blood during operation and operative time were also significantly increased, but the complicative incidence, mortality and hospitalized days after D4 operation did not increase significantly. Conclusion D4 lymphadenectomy for AGC is safe, reasonable and feasible.

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