联合脏器切除治疗局部晚期贲门癌37例分析

Multi-visceral resection in the treatment of local advanced cardiac carcinoma: an analysis of 37 cases

目的探讨贲门癌侵及周围脏器的联合脏器切除术的适应证、手术技术及并发症的防治。方法回顾性分析1994年6月至2004年7月37例贲门癌直接侵及胃体、胃底、胰和脾施行联合脏器切除治疗局部晚期贲门癌病人的临床资料。结果手术死亡率为2·7%(1/37),主要并发症发生率为25·0%。1、3、5年总的存活率分别为:69·4%(25/36),44·4%(16/36),19·4%(7/36)。手术死亡率和并发症发生率与标准贲门癌切除术相比差异无显著性,预后与标准贲门癌切除术亦相近。结论局部晚期贲门癌的联合脏器切除术可提高贲门癌的切除率,改善生活质量,提高5年存活率,值得临床推广应用。

Objective To evaluate the indications and surgical procedure of combined viscera resection for local advanced cardiac carcinoma, and the prevention and treatment of complications. Methods From June 1994 to July 2004，37 cases of cardiac carcinoma invading peripheral viscera were treated with en bloc resection combined other organs. The resuits were retrospectively analyzed. Results The operative mortality rate was 2.7% （1/37）. The morbidity of main complications was 25.0 %. The overall 1-，3-and 5-year survival rates were 69.4 % ,44.4% and 19.4% respectively. There was no significant difference in operative mortality and morbidity of complications between combined viscera resection of cardiac carcinoma and routine proximal gastrectomy （ P 〉 0.05 ）. The prognoses were similar in both groups. Conclusion Extended resection of cardiac carcinoma involving peripheral viscera improves the resectional rate, the quality of life and 5-year survival rate.