关键词: 全胃切除, 近端胃癌根治切除, 并发症, 营养, 生活质量

Abstract: 【Abstract】〓Objective〓To compare complications, nutritional status and quality of life between total gastrectomy and proximal radical gastrectomy in patients with advanced proximal gastric carcinoma. Methods〓Eighty-five patients with proximal stomach cancer were enrolled from Jan 2002 to Dec 2008 and underwent total gastrectomy (total gastrectomy group,n=40) and proximal radical gastrectomy (proximal radical gastrectomy group,n=45). Nutritional status, incidence of reflux esophagitis and cholecystolithiasis, 5-year survival rate, quality of life were investigated. Results〓Median survival time of total gastrectomy group and proximal radical gastrectomy group were 41 months and 46 months respectively. There was no significant difference in 5-year survival rate between two groups (P>0.05). There was significant difference in incidence of reflux esophagitis between total gastrectomy group and proximal radical gastrectomy group (10/40, 25% vs. 4/45, 8.9%, P<0.05). There was significant difference in incidence of cholecystolithiasis between total gastrectomy group and proximal radical gastrectomy group (11/40, 27.5% vs. 4/45, 8.9%,P<0.05). Hemoglobin, albumin, vitamin B12 and ferritin in proximal radical gastrectomy group were higher than those in total gastrectomy group (142.2±10.6 vs. 128.4±11.4; 41.3±5.8 vs. 35.9±3.8; 271.5±39.7 vs. 184.5±24.6; 220.2±59.7 vs. 170.2±27.6; P<0.05). Diet and labor in proximal radical gastrectomy group were better than those in total gastrectomy group (P<0.05). Conclusion〓Proximal radical gastrectomy decreases incidence of reflux esophagitis and cholecystolithiasis, improve nutritional status and quality of life.

Key words: Total gastrectomy, Proximal radical gastrectomy, Complication, Nutrition, Quality of life