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目的:观察近端胃切除和全胃切除对近端胃癌的疗效。方法:比较28例患有早期近端胃癌接受近端胃切除28例患者与100例患有早期近端胃癌接受全胃切除的患者,观察近端胃切除是否优于全胃切除。结果:两种治疗方法手术时间、术后并发症(包括吻合口瘘)没有差异。两组患者胃切除后的代谢变化结果相似,体重,血清血红蛋白以及血清总蛋白浓度变化相近。近端胃切除后腹泻(32%)和胃食管返流(28%)最为常见,而全胃切除后餐后腹胀(21%)最为常见。二者的术后5年生存率没有明显差别。结论:近端胃切除不会由于残余胃的生理优势而优于全胃切除术。
Objective: To observe the effect of proximal gastrectomy and total gastrectomy on proximal gastric cancer. Methods: 28 patients with proximal proximal gastric cancer who received proximal gastrectomy and 100 patients who undergone total gastrectomy for early proximal gastric cancer were enrolled in this study. To compare whether proximal gastrectomy is better than total gastrectomy. Results: There was no difference in operative time, postoperative complications (including anastomotic fistula) between the two treatments. Metabolic changes after gastrectomy in both groups were similar, with changes in body weight, serum hemoglobin, and serum total protein concentrations similar. Diarrhea after proximal gastrectomy (32%) and gastroesophageal reflux (28%) are most common, whereas postprandial bloating (21%) is most common after total gastrectomy. The postoperative 5-year survival rate of the two did not differ significantly. CONCLUSIONS: Proximal gastrectomy does not surpass gastrectomy due to the physiological advantages of residual stomach.