分析胃癌根治术对肿瘤未直接侵犯胰腺被膜及横结肠系膜前叶胃癌患者生存率情况影响。

选取2010年8月至2012年8月间在西安凤城医院接受根治术治疗的胃癌患者133例，依据随机数字表法将其分成观察组（66例）与对照组（67例）。观察组术中切除横结肠系膜前叶和胰腺被膜，对照组术中保留横结肠系膜前叶和胰腺被膜。比较两组患者临床资料、手术情况，采用Kaplan-Meier法计算生存率，单因素分析观察组患者术后癌转移的影响因素。

观察组患者的手术时间及淋巴结清扫数显著多于对照组，差异有统计学意义（t=3.613、4.222，均P<0.01）；观察组患者术后病理检测显示有5例（7.58%）出现癌转移，转移率在临床分期、浸润深度、淋巴结转移程度、肿瘤前后壁位置方面差异有统计学意义（均P<0.05）。Logistic回归分析显示临床分期、浸润深度、淋巴结转移范围为患者癌转移独立危险因素；两组患者平均生存时间和1、3、5年生存率比较，差异均无统计学意义（t=1.240，χ²=0.086、0.038、0.513，均P>0.05）。

淋巴结转移程度高、临床分期晚及肿瘤浸润程度高的胃癌患者越易出现横结肠系膜前叶和胰腺被膜转移，胃癌根治手术中切除横结肠系膜前叶和胰腺被膜对患者手术生存率没有显著影响。

To analyze the effect of radical gastrectomy on the survival rate of patients with no invasion of anterior lobe of transverse mesocolon or pancreatic capsule.

From August 2010 to August 2012, one hundred and thirty-three patients with gastric cancer who underwent radical gastrectomy in Xi’an Fengcheng Hospital were divided into the observation group (66 cases) and the control group (67 cases), according to the random number table. In the observation group, the anterior transverse transectional mesial membrane and the pancreas capsule were removed during the operation. The control group retained the anterior lobe of transverse mesocolon and pancreatic capsule. The clinical data and operation conditions between the two groups were compared. Survival rate was calculated by Kaplan-Meier method. Univariate analysis was used to fine out the factors influencing postoperative cancer metastasis in the observation group.

The operation time, number of lymph node dissection in the observation group were significantly more than those in the control group (t=3.613, 4.222, both P<0.01). Pathological examination in the observation group showed that 5 cases (7.58%) had cancer metastasis and metastasis rates were significantly different in clinical stage, depth of invasion, lymph node metastasis and tumor location (all P<0.05). Logistic regression analysis showed that the clinical stage, depth of invasion and lymph node transfer range were independent risk factors for cancer metastasis. There were no significant differences between the two groups in the mean survival time and the 1-, 3-, 5-year survival rate (t=1.240, χ²=0.086, 0.038, 0.513, all P>0.05).

For patients with high degree of lymph node metastasis, late clinical stage and high degree of tumor infiltration are more likely to have metastasis to the anterior mesangial membrane and pancreas. The radical resection of the anterior gingival membrane and pancreas in radical surgery has no significant effect on the survival rates.