中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (02): 147-149.

• 论著 • 上一篇    下一篇

食管胃结合部腺癌病人行近端与全胃切除术后生活质量比较

代    斌a，潘    琳b，杨    晨b，刘    杰a，陈心足a，杨    昆a，胡建昆a，张    波a，陈志新a，陈佳平a   

  1. 四川大学 a.华西医院胃肠外科中心  b.华西临床医学院临床医学系，四川成都610041
  • 出版日期:2011-02-01 发布日期:2011-05-30

  • Online:2011-02-01 Published:2011-05-30

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摘要：

目的    比较食管胃结合部腺癌（AEG）（Siewert分型Ⅱ/Ⅲ型）病人行近端胃切除（PG）与全胃切除（TG）术后生活质量的差异。方法    回顾性分析2006年1月至2009年12月四川大学华西医院胃肠外科胃癌专业组AEG（Ⅱ/Ⅲ型）的资料，PG者行食管-残胃吻合，TG者行食管-单管空肠横结肠前Roux-en-Y重建。术后6个月后行电话随访，采用欧洲癌症研究和治疗组织生活质量问卷（QLQ）-C30和QLQ-STO22量表评估术后生活质量。 结果  98例符合AEG（Ⅱ/Ⅲ型），随访期内死亡30例，失访8例，纳入分析PG组40例，TG组20例。两组病人的性别、年龄、肿瘤大小、TNM分期（AJCC 6版）、术后住院时间等基线指标差异无统计学意义。TG组总体健康状况评分略优于PG组，但差异无统计学意义（P=0.072）。术后单项症状方面，PG组在反流症状，进食困难、进食限制、恶心呕吐、食欲下降、味觉改变、社交能力以及睡眠方面评分差于TG组（P<0.05）；TG组呼吸困难症状评分差于PG组（P=0.027）。 结论    AEG（Ⅱ/Ⅲ型）病人行全胃切除术后生活质量较近端胃切除为优，尤其在控制反流、改善食欲等方面优势更为明显。

关键词: 食管胃结合部腺癌, 全胃切除术, 近端胃切除术, 生活质量

Abstract:

Comparison of quality of life between proximal versus total gastrectomy for adenocarcinoma of gastroesophageal junction        DAI Bin*, PAN Lin, YANG Chen, et al. *Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
Corresponding author: HU Jian-kun, E-mail: hujkwch@126.com
Abstract    Objective    To compare quality of life (QLQ) after proximal gastrectomy (PG) or total gastrectomy (TG) for adenocarcinoma of gastroesophageal junction (AEG) (Siewert type II/III). Methods    Siewert type II/III AEG cases performed either PG with esophagogastric anastomosis or TG with Roux-en-Y esophagojejunal reconstruction between January 2006 and December 2009 at West China Hospital of Sichuan University were analyzed retrospectively. Patients were followed up by telephone at six months or more after the surgery and QLQ was assessed by EORTC QLQ-C30 and QLQ-STO22 questionnaires. Results    A total of 98 cases were Siewert type II/III AEG with 30 dead and 8 lost to follow up. Data from 40 cases in PG group and 20 in TG group were analyzed. There were no significant differences of baselines between two groups related to sex, age, tumor size, TNM stage (AJCC, 6th version) or hospital stay after surgery. TG group scored better than PG group in global health status without significant difference (P=0.072). PG group reported worse scores than TG group with respect to reflux symptoms, dysphagia, eating restrictions, nausea and vomiting, appetite loss, taste abnormality, social functioning and insomnia (P<0.05). Moreover, TG group scored worse than PG group regarding to dyspnoea (P=0.027). Conclusion    Siewert type II/III AEG patients treated by TG have a better QLQ than that of PG, especially on the aspects of reflux controlling and appetite improvement.

Key words: adenocarcinoma of gastroesophageal junction, total gastrectomy, proximal gastrectomy, quality of life