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为了使胃癌患者获得较好的术后生活质段,日本Akita大学医学院外科于1989年至1991年期间对作过胃癌保留幽门胃切除术病例进行前瞻性研究,与常规远端胃切除病例在手术持续时间、失血量、术后早期并发症、内窥镜检查所见、胃液pH和胆囊功能等方面进行比较.对胃癌病例保留幽门胃切除术作出早期术后评价.病人和方法:早期胃癌64例,癌肿位于胃体中部1/3,最大径<2.0cm;肿瘤2～4cm于胃大弯粘膜癌隆起型(ⅡA)胃癌.入外科作保留幽门胃切除术(PPG)35例,按常规远端胃切除术(CDG)29例.PPG手术时保留幽门管1.5cm,同时保留迷走神经的肝支和幽门支、右胃血管及幽门上淋巴结.切除胃大弯和小弯淋巴结、幽门下淋巴结和胃左动脉淋巴结.而CDG组病例是1组和2组淋巴结都切除,进行胃十二指肠重建.术后按预定项目进行1年随访,结果用均值±SEM表示经t测试,P值均<0.05,有显著意义.
In order to obtain a better postoperative quality of life for patients with gastric cancer, the surgical department of Akita University School of Medicine in Japan carried out a prospective study of pylorus gastrectomy cases performed in gastric cancer from 1989 to 1991, and was compared with conventional distal gastrectomy cases. The duration of surgery, blood loss, early postoperative complications, endoscopic findings, gastric juice pH, and gallbladder function were compared. An early postoperative evaluation of gastric pylorus gastrectomy was performed. Patients and Methods: Early Gastric Cancer In 64 cases, the cancer was located in the central 1/3 of the corpus, and the maximum diameter was <2.0cm; the tumor was 2~4cm in the gastric lordosis (IIA) gastric cancer. 35 cases were treated with preserved pylorus gastrectomy (PPG). Conventional distal gastrectomy (CDG) in 29 cases. PPG surgery to retain the pylorus 1.5cm, while retaining the vagus nerve of the liver and pylorus, right gastric vessels and pyloric lymph nodes. Resection of gastric curvature and small curved lymph nodes, pylorus Lower lymph nodes and left gastric artery lymph nodes. In the CDG group, lymph nodes of both groups 1 and 2 were resected for gastroduodenal reconstitution. Postoperative follow-up for 1 year was performed according to a predetermined schedule. Mean ± SEM was used to represent t-tests. P values were <0.05, significant.