Analysis of total grastrectomy and proximal subtotal gastrectomy in gastric cardia and fundus carcinoma / 中国综合临床

ABSTRACT

Objective To explore the value of total grastrectomy in gastric cardia and fundus carcinoma. Methods 118 cases with cardiac cancer were treated by surgical treatment, those patients were admitted between May 1998 and May 2007 in Affiliated Baiyin Hospital of Lanzhou University. Of them,65 cases were treated by total gastractomy (group A),and 53 cases were treated by proximal gastractomy (group B). The degree of invasion, lymph node dissection, postoperative complication rate and survival rate were compared. Results The average num-ber of lymph node were 19.4±3.9 and 15.2±2.6 (P<0.05), respectively. The occurrence of lymph node metasta-sis were 40.8% (514/1261) and 54.8% (441/806),respectively. Of them, the occurrence of metastasis of lymph node of No. 5、No. 6 in group A were 15.4% (10/65)and 12.3% (8/65),respectively. The postoperative complica-tion rate were 7.7% (5/65) and 13.2% (7/53). The 1,3, and 5 year survival rates were 63.1%,46.2%,30.8% in group A and 66.0%,36.9%, 18.5% in group B, with significant differences beteen two groups in 3, 5 year sur-vival rates(P<0.05). Conclusion The way of total grastrectomy is better in cleaning lymph node than that of proximal gastrectomy, and dosen't increase the postoperative complication rate but improves 3-year and 5-year sur-vival rates in cases with cardiac cancer of Ⅰ, Ⅱ, Ⅲ stage.