胃贲门癌经腹手术切除(附50例报告)

Resection of Carcinoma of the Gastric Cardia by Abdominal Approach Report of 50 Cases

本文报告50例胃贲门癌经腹手术病人,其切除率为60％(30/50),术后并发症发生率为6％(3/50),没有手术死亡,所有病人都痊愈出院。术后经随访,1、3、5年生存率分别为77％(20/26),47.6％(10/21)和35.3％(6/17)。作者认为:胃贲门癌患者,如果具备以下条件之一者,应首选剖腹探查。1.高龄体弱,不能耐受开胸手术者;2.慢性呼吸系统疾病伴肺功能不全者;3.心血管系统疾病伴心功能不全者;4.X线钡检表现有软组织块影,膈肌增厚,腹段食管抬高或钡剂分流等某两种以上征象者;5.残胃贲门癌或上腹部曾有手术史者。

Fifty patients with gastric cardiac cancer resected by abdominal approach were reported. The resection rate was 60% (30/50) and postoperative complications occur- red in 6% (3/50) of the cases. There was no operative death. The 1-, 3-, and 5-year survival rates were 77% (20/26), 47.6% (10/21) and 35.3% (6/17) respectively. The authors believe that exploration by abdominal approach should be given the first priority under any one of the following conditions: 1. patients too old or weak to stand trans-thoracic approach, 2. chronic respiratory diseases with impaired pul- monary function, 3. diseases of cardiovascular system with cardiac hypofunction, 4. roentgenological evidence of any two of the following filldings: shadow of tumor mass, diaphragmatic thickening, elevation of abdominal esophagus and diversion of barium-stream passage into stomach, 5. past history of tipper abdominal operation or cardiac cancer in gastric stump.