• 四川大學(xué)華西醫(yī)院胃腸外科中心(四川成都 610041);

目的  探索食管胃結(jié)合部腺癌(AEG)患者行經(jīng)腹近端胃切除與全胃切除術(shù)后生活質(zhì)量的差異。
方法  選擇2011年1月至2012年3月期間于四川大學(xué)華西醫(yī)院胃腸外科中心行經(jīng)腹近端胃切除術(shù)(近端胃切除組) 或全胃切除術(shù)(全胃切除組)的85例AEG患者作為研究對象,于術(shù)后12個月,采用生活質(zhì)量核心問卷30 (QLQ-C30)和胃癌特異性評價量表(QLQ-STO22)測量其生活質(zhì)量,并進(jìn)行組間比較。
結(jié)果  2組患者的年齡、性別等臨床病理特征的差異均無統(tǒng)計學(xué)意義(P>0.05),具有可比性。近端胃切除組患者在飲食受限、腹瀉及氣促方面的得分低于全胃切除組(P<0.05),而在味覺改變和反流方面的得分高于全胃切除組患者(P<0.05)。2組患者的其他項目得分比較差異均無統(tǒng)計學(xué)意義(P>0.05)。
結(jié)論 ?、蛐秃廷笮虯EG患者行近端胃切除+管狀胃重建和全胃切除+Roux-en-Y吻合術(shù)后都有不同程度的并發(fā)癥發(fā)生。近端胃切除術(shù)在飲食受限、腹瀉以及氣促方面的效果更優(yōu);而全胃切除術(shù)在反流和味覺改變方面的效果更優(yōu)。

引用本文: 沈朝勇,楊宏鑫,張波,陳海寧,陳志新,陳佳平. 近端胃切除術(shù)與全胃切除術(shù)對食管胃結(jié)合部腺癌患者生活質(zhì)量的影響. 中國普外基礎(chǔ)與臨床雜志, 2013, 20(12): 1381-1385. doi: 復(fù)制

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2. Hasegawa S, Yoshikawa T. Adenocarcinoma of the esophagogastric junction:incidence, characteristics, and treatment strategies[J]. Gastric Cancer, 2010, 13(2):63-73.
3. Shiraishi N, Hirose P, Morimoto A, et al. Gastric tube reconstru-ction prevented esophageal reflux after proximal gastrectomy[J]. Gastric Cancer, 1998, 1(1):78-79.
4. Chen XF, Zhang B, Chen ZX, et al. Gastric tube reconstruction reduces postoperative gastroesophageal reflux in adenocarcinoma of esophagogastric junction[J]. Dig Dis Sci, 2012, 57(3):738-745.
5. Matsui H, Igarashi N, Itano O, et al. Laparoscopic function-preserving surgery for early gastric cancer in the upper third of the stomach:vagus-sparing proximal gastrectomy with side-to-side esophagogastric-tube anastomosis[J]. Tokai J Exp Clin Med, 2007, 32(4):109-114.
6. Shiraishi N, Adachi Y, Kitano S, et al. Clinical outcome of proximal versus total gastrectomy for proximal gastric cancer[J].World J Surg, 2002, 26(9):1150-1154.
7. Wen L, Chen XZ, Wu B, et al. Total vs. proximal gastrectomy for proximal gastric cancer:a systematic review and meta-analysis[J]. Hepatogastroenterology, 2012, 59(114):633-640.
8. Barbour AP, Lagergren P, Hughes R, et al. Health-related qualityof life among patients with adenocarcinoma of the gastro-esophageal treated by gastrectomy or esophagectomy[J]. British J Surg, 2008, 95(1):80-84.
9. Washington K. 7th edition of the AJCC cancer staging manual:stomach[J]. Ann Surg Oncol, 2010, 17(12):3077-3079.
10. Deans C, Yeo MS, Soe MY, et al. Cancer of the gastric cardia is rising in incidence in an Asian population and is associated with adverse outcome[J]. World J Surg, 2011, 35(3):617-624.
11. Harrison LE, Karpeh MS, Brennan MF. Total gastrectomy is not necessary for proximal gastric cancer[J]. Surgery, 1998, 123(2):127-130.
12. An JY, Youn HG, Choi MG, et al. The difficult choice between total and proximal gastrectomy in proximal early gastric cancer[J].Am J Surg, 2008, 196(4):587-591.
13. Kaptein AA, Morita S, Sakamoto J. Quality of life in gastric cancer[J]. World J Gastroenterol, 2005, 11(21):3189-3196.
14. Takiguchi S, Yamamoto K, Hirao M, et al. A comparison of postoperative quality of life and dysfunction after Billroth Ⅰ and Roux-en-Y reconstruction following distal gastrectomy for gastric cancer:results from a multi-institutional RCT[J]. Gastric Cancer,2012, 15(2):198-205.
15. Park SH, Cho MS, Kim YS, et al. Self-reported health-related quality of life predicts survival for patients with advanced gastric cancer treated with first-line chemotherapy[J]. Qual Life Res, 2008, 17(2):207-214.
16. 李文英, 曹淑紅, 張曉峰, 等. 胃癌術(shù)后患者生活質(zhì)量研究[J]. 現(xiàn)代預(yù)防醫(yī)學(xué), 2011, 38(21):4441-4443, 4446.
17. Aaronson NK, Ahmedzai S, Bergman B, et al. The European organization for research and treatment of cancer QLQ-C30:a quality-of-life instrument for use in international clinical trials in oncology[J]. J Natl Cancer Inst, 1993, 85(5):365-376.
18. Blazeby JM, Conroy T, Bottomley A, et al. Clinical and psycho-metric validation of a questionnaire module, the EORTC QLQ-STO22, to assess quality of life in patients with gastric cancer[J].Eur J Cancer, 2004, 40(15):2260-2268.
19. 姜寶法, 徐濤, 劉春曉, 等. 胃癌患者生活質(zhì)量問卷(QLQ-STO22)中文版的制定[J]. 中國心理衛(wèi)生雜志, 2005, 19(5):310-312.
20. Zhao H, Kanda K. Translation and validation of the standard Chinese version of the EORTC QLQ-C30[J]. Qual Life Res, 2000, 9(2):129-137.
21. Collard JM, Romagnoli R. Roux-en-Y jejunal loop and bile reflux[J]. Am J Surg, 2000, 179(4):298-303.
22. 陳秀峰, 陳海寧, 張波, 等. Ⅱ、Ⅲ型食管胃結(jié)合部腺癌的臨床分析[J]. 四川大學(xué)學(xué)報:醫(yī)學(xué)版, 2012, 43(2):289-292.
23. 代斌, 潘琳, 楊晨, 等. 食管胃結(jié)合部腺癌病人行近端胃與全胃切除術(shù)后生活質(zhì)量比較[J]. 中國實用外科雜志, 2011, 31(2):147-149.
24. Bae JM, Kim S, Kim YW, et al. Health-related quality of life among disease-free stomach cancer survivors in Korea[J]. Qual Life Res, 2006, 15(10):1587-1596.
25. Wu CW, Chiou JM, Ko FS, et al. Quality of life after curativegastrectomy for gastric cancer in a randomised controlled trial[J].Br J Cancer, 2008, 98(1):54-59.
  1. 1. Siewert JR, Stein HJ, Feith M. Adenocarcinoma of the esophago-gastric junction[J]. Scand J Surg, 2006, 95(4):260-269.
  2. 2. Hasegawa S, Yoshikawa T. Adenocarcinoma of the esophagogastric junction:incidence, characteristics, and treatment strategies[J]. Gastric Cancer, 2010, 13(2):63-73.
  3. 3. Shiraishi N, Hirose P, Morimoto A, et al. Gastric tube reconstru-ction prevented esophageal reflux after proximal gastrectomy[J]. Gastric Cancer, 1998, 1(1):78-79.
  4. 4. Chen XF, Zhang B, Chen ZX, et al. Gastric tube reconstruction reduces postoperative gastroesophageal reflux in adenocarcinoma of esophagogastric junction[J]. Dig Dis Sci, 2012, 57(3):738-745.
  5. 5. Matsui H, Igarashi N, Itano O, et al. Laparoscopic function-preserving surgery for early gastric cancer in the upper third of the stomach:vagus-sparing proximal gastrectomy with side-to-side esophagogastric-tube anastomosis[J]. Tokai J Exp Clin Med, 2007, 32(4):109-114.
  6. 6. Shiraishi N, Adachi Y, Kitano S, et al. Clinical outcome of proximal versus total gastrectomy for proximal gastric cancer[J].World J Surg, 2002, 26(9):1150-1154.
  7. 7. Wen L, Chen XZ, Wu B, et al. Total vs. proximal gastrectomy for proximal gastric cancer:a systematic review and meta-analysis[J]. Hepatogastroenterology, 2012, 59(114):633-640.
  8. 8. Barbour AP, Lagergren P, Hughes R, et al. Health-related qualityof life among patients with adenocarcinoma of the gastro-esophageal treated by gastrectomy or esophagectomy[J]. British J Surg, 2008, 95(1):80-84.
  9. 9. Washington K. 7th edition of the AJCC cancer staging manual:stomach[J]. Ann Surg Oncol, 2010, 17(12):3077-3079.
  10. 10. Deans C, Yeo MS, Soe MY, et al. Cancer of the gastric cardia is rising in incidence in an Asian population and is associated with adverse outcome[J]. World J Surg, 2011, 35(3):617-624.
  11. 11. Harrison LE, Karpeh MS, Brennan MF. Total gastrectomy is not necessary for proximal gastric cancer[J]. Surgery, 1998, 123(2):127-130.
  12. 12. An JY, Youn HG, Choi MG, et al. The difficult choice between total and proximal gastrectomy in proximal early gastric cancer[J].Am J Surg, 2008, 196(4):587-591.
  13. 13. Kaptein AA, Morita S, Sakamoto J. Quality of life in gastric cancer[J]. World J Gastroenterol, 2005, 11(21):3189-3196.
  14. 14. Takiguchi S, Yamamoto K, Hirao M, et al. A comparison of postoperative quality of life and dysfunction after Billroth Ⅰ and Roux-en-Y reconstruction following distal gastrectomy for gastric cancer:results from a multi-institutional RCT[J]. Gastric Cancer,2012, 15(2):198-205.
  15. 15. Park SH, Cho MS, Kim YS, et al. Self-reported health-related quality of life predicts survival for patients with advanced gastric cancer treated with first-line chemotherapy[J]. Qual Life Res, 2008, 17(2):207-214.
  16. 16. 李文英, 曹淑紅, 張曉峰, 等. 胃癌術(shù)后患者生活質(zhì)量研究[J]. 現(xiàn)代預(yù)防醫(yī)學(xué), 2011, 38(21):4441-4443, 4446.
  17. 17. Aaronson NK, Ahmedzai S, Bergman B, et al. The European organization for research and treatment of cancer QLQ-C30:a quality-of-life instrument for use in international clinical trials in oncology[J]. J Natl Cancer Inst, 1993, 85(5):365-376.
  18. 18. Blazeby JM, Conroy T, Bottomley A, et al. Clinical and psycho-metric validation of a questionnaire module, the EORTC QLQ-STO22, to assess quality of life in patients with gastric cancer[J].Eur J Cancer, 2004, 40(15):2260-2268.
  19. 19. 姜寶法, 徐濤, 劉春曉, 等. 胃癌患者生活質(zhì)量問卷(QLQ-STO22)中文版的制定[J]. 中國心理衛(wèi)生雜志, 2005, 19(5):310-312.
  20. 20. Zhao H, Kanda K. Translation and validation of the standard Chinese version of the EORTC QLQ-C30[J]. Qual Life Res, 2000, 9(2):129-137.
  21. 21. Collard JM, Romagnoli R. Roux-en-Y jejunal loop and bile reflux[J]. Am J Surg, 2000, 179(4):298-303.
  22. 22. 陳秀峰, 陳海寧, 張波, 等. Ⅱ、Ⅲ型食管胃結(jié)合部腺癌的臨床分析[J]. 四川大學(xué)學(xué)報:醫(yī)學(xué)版, 2012, 43(2):289-292.
  23. 23. 代斌, 潘琳, 楊晨, 等. 食管胃結(jié)合部腺癌病人行近端胃與全胃切除術(shù)后生活質(zhì)量比較[J]. 中國實用外科雜志, 2011, 31(2):147-149.
  24. 24. Bae JM, Kim S, Kim YW, et al. Health-related quality of life among disease-free stomach cancer survivors in Korea[J]. Qual Life Res, 2006, 15(10):1587-1596.
  25. 25. Wu CW, Chiou JM, Ko FS, et al. Quality of life after curativegastrectomy for gastric cancer in a randomised controlled trial[J].Br J Cancer, 2008, 98(1):54-59.