摘要
目的探讨进展期胃癌手术路径的合理选择以及手术技巧与并发症的预防。方法回顾总结我院1990-2004年经根治性手术治疗的36例胃上部癌的临床资料,其中经腹手术20例,经胸或胸腹部联合手术16例。结果经腹手术在缩小手术创伤、减少出血量及手术并发症方面占有一定的优势,安全性较好,但亦有一定的局限性。结论手术路径的选择主要应依据肿瘤的具体情况而定,合理掌握指征。对于非贲门胃上部癌、食管侵犯在2cm或以下者以及BormannI、II型的胃上部癌应优先考虑经腹路径的手术。
Objective To explore the reasonable selection of operative pathw ay, surgical skill, and prevention ofcom plication in superior advanced gastric carcinom a. M ethods 36 patients with superior advanced gastric carcino-m a received radical operation from 1990 to 2004 w ere review ed. Tw enty cases w ith abdom inal incision and 16cases w ith thoracotom y or badom ino-thoracic incision. Results The com parative analysis indicated that abdom inalincision had an advantage in reducing operative injury, decreasing hem orrhage and com plication. Conclusions se-lection of operative pathw ay m ust depend upon trm our conditions. Although abdom inal resection is a securerm ode. but should be paid attention to the indications. On the condition of insuring radical treatm ent, especially forsuch cases of superior gastric carcinom a as non-cardiac part, oesophageal involvem ent≤2cm or Borrm ann I-IItype, abdom inal resection ought to be top-priority.
