术前不同检查对贲门癌切除可能性的估价

Evaluation of the Resectibility of Cardiac Carcinoma by Way of Different Preoperative Examinations

我院经钡餐造影手术治疗贲门癌450例,切除298例,切除率66.2%。应用 B 超探查贲门癌118例,选择100例进行手术,切除83例。切除率83%,明显高于钡餐组。肿瘤<5cm 无明显外侵和胃左动脉淋巴结转移72例,切除68例,列为手术适应证。肿瘤>5cm 伴有外侵而无淋巴结转移的28例,切除15例,明显低于前者,列为手术相对适应证。对肝脏、胰腺、脾门和远处淋巴结有转移的列为手术禁忌证。临床实践证明,超声检查优于常规 X 线造影,超声对肿瘤外侵和转移的主要表现,是临床术前估计能否手术切除的重要依据。

Four hundred and fifty patients with cardiac carcinoma who had been examined by barium meal were operated on in our hospital.298 had resectable tumors,the resection rate was 66.%;118 pa- tients,of which 100 cases were operated,had been examined by B-mode ultrasonography.83 had re- sectable tumors,the resection rate was 83%,which was higher than that of the group of barium meal examination.The absolute indications of operation include less than 5cm tumors detected by B-mode ultrasonography,no obvious external invasion and no metastases of lymph node of left gastric artery. We had 72 patients with such the tumors,of whom,68 were resected.We had also 28 patients with external invasion and lymph node metastases,whose tumor sizes were more than 5cm,the resection rate was obviously lower than the former,in this way,exploration may be considered.Those who had metastases of liver,pancreas and hilus of spleen,should not be explored.It is confirmed by clin- ical practice that the examination of B-mode ultrasonography is in advance of the barium meal exami- nation.B-mode ultrasonography can show the external invasion and metastases of tumors,it can pro- vide the important basis for preoperatively evaluating the resectibility of cardiac carcinoma.