经腹膈肌切开器械吻合治疗贲门癌

Treating Cardiac Carcinoma with Appliance Anastomose Via Diaphragm

目的评价经腹膈肌切开器械吻合治疗贲门癌的效果。方法回顾分析作者1996年5月-2004年5月所完成的经腹膈肌切开器械吻合治疗贲门癌238例的围手术期经验,总结其手术方法对贲门癌患者带来的利弊。结果238例贲门癌手术切除234例(切除率98.3%),因广泛转移不能切除4例,所有切除者术后病检切端均无癌残留。术后发生肺部感染6例(2.5%),切口感染1例(0.4%),下肢深静脉血栓形成5例(2.1%),无吻合口漏和吻合口狭窄,无围手术期死亡。随访1年以上的病例230例(未切除者4例未列入随访范围),失访4例,其中1年生存率100%,3年生存率60.2%,5年生存率37.2%。所有随访病人中,返流性食道炎16例(7.0%)。结论经腹膈肌切开器械吻合治疗贲门癌创伤小,术后并发症少,不影响手术切除率及术后生存时间,对贲门癌患者是一种恰当的手术方法,尤其适用于有合并症的高龄患者。

Objective To evaluate the effect of treating cardiac carcinoma with appliance anastomose via diaphragm . Methods A retrospective review of the author＇ s perioperative period experience that 238 eases with cardiac carcinoma were treated by appliance anastomose via diaphragm performed from 1996 to 2004 . The advantages and disadvantages with this method for these patients were summarized. Results 238 cases were performed （ the resection rate was 98.3% ） , 4 cases couldn＇ t be performed for comprehensive metastasis. All the operations proved that the end of incisions have no carcinoma eell left by pathology. Pulmonary infection occurred in 6 cases （2.5%） , Infection of incision occurred in one case （0.4%） , Thrombus occurred in deep veins of lower limb in 5 cases （2. 1% ）. No cases were found in anastomotic leak or anastomotic stenosis. Perioperative death occurred in no ease. 230 eases were followed up more than one year . 1,3,5 - year Survival rates were 100% ,60.2% , 37.2% respectively, GERD was occurred in 16 cases （7.0%）. Conclcusion The method of treating cardiac carcinoma with appliance anastomose via diaphragm is safe,less complications after operation . this is a appropriate method, especially for advanced age with complications .