Abstract: Objective To explore the effect of proximal minimally invasive gastrectomy for patients with early-stage proximal gastric cancer. Methods 100 patients with proximal gastric cancer who underwent surgery from January 2007 to January 2012 were enrolled, 50 of whom underwent proximal minimally invasive gastrectomy and 50 underwent total gastrectomy. Surgical conditions, complications, nutritional status, and Visik scores of gastroesophageal reflux were compared between the two groups.Results In terms of operating time, lymphatic cleaning, statistical significance was not showed on them between two groups (P>0.05). In terms of blood loss, volume of experiment group was less than that of control group, statistical significance was showed on them (P<0.05). Compared early and late complications, exhaust time, eating time between two groups, statistical significance was not showed on them (P>0.05). In gastric cancer pathological conditions, statistical significance was not showed on them between two groups (P>0.05).The statistical significance was not showed on preoperative and postoperative nutritional status between two groups (P>0.05). The Visik score of experiment group is significantly higher than that of control group, statistical significance was showed on them (P<0.05). Conclusion Proximal minimally invasive proximal gastrectomy is a reliable and safe choice for gastric cancer patients, patients have good postoperative recovery, it has a high incidence of gastroesophageal reflux, but it is worth in clinical application.

Key words: gastric cancer, total gastrectomy, laparoscopic proximal gastrectomy

摘要： ［摘要］ 目的 探讨近端微创胃切除手术对于近端早期胃癌的效果。方法 选取2007 年1 月至2012 年 1 月在我院接受手术治疗的近端胃癌患者 100 例，其中 50 例接受近端微创胃切除术为试验组，50 例接受胃全切除术为对照组，比较两组的手术情况、并发症、营养状况及胃食管反流Visik 评分。结果 在手术时间、淋巴清扫方式方面，两组相比差异不具有统计学意义（P>0.05）， 而在手术失血量方面，近端胃切除组少于全胃切除组（P<0.05）。两组在排气时间、进食时间差异不具有统计学意义（P>0.05），但胃近端切除组在胃食管反流、贫血发生例数少于全胃切除组（P<0.05），且全胃切除组术后 6 个月体重下降、术后血红蛋白水平、红细胞计数以及预后营养指数的下降比近端胃切除组明显并具有统计学意义（P<0.05）。近端胃组 Visik 评分明显比全胃组高，差异具有统计学意义（P<0.05）。结论 近端微创胃切除术对于近端胃癌患者来说，术后的恢复良好，胃食管反流的发生率低，是一种可靠且安全的选择。

关键词: 胃癌, 全胃切除术, 近端胃切除术