胸腹联合切口切除贲门癌598例体会

A study of the surgical treatment of carcinoma of gastric cardia by abdominothoracic

目的:探讨胸腹联合切口在贲门癌手术中的应用。方法:回顾性分析1996年6月～2006年2月采用胸腹联合切口治疗贲门癌598例临床资料。结果:根治性切除576例(切除率96.3%),姑息性切除15例,单纯探查7例。并发症发生率为4.7%(28/598),其中吻合口瘘4例,吻合口狭窄3例,呼吸衰竭3例,肺部感染11例,脓胸2例,乳糜胸1例,心衰4例(死亡1例)。结论:经胸腹联合切口治疗贲门癌有利于肿瘤切除及周围淋巴结清扫,能够提高手术切除率,并发症少,在一定程度上优于左侧单纯开胸或剖腹手术。

Objective：To study the clinical value of surgical treatments of carcinoma of the gastric cardia approached by addominothoracic incision. Methods： The clinical data of 598 cases with carcinoma of gastric cardia treatmed thoracico -abdominal incision from June 1996 to February 2006 were analyzed retrospectively. Results： Of 598 cases 576 cases underwent complete resection of the tumor, 15 cases underwent palliative surgery and 7 cases underwent single exporing operation without lumcre resector. There were 4 cases with anastomotic leakages3 cases with anastomosis stricture,3 cases with respiration failure, 1 1 with pneumonia, 2 with empyema, 1 with chylothorax and 4 cases with heart failure（ 1 case＇s dead）. Total postoperative complication rate was 4.7%. Conclusion： The treatment with abdominothoracic incision with the carcinoma of gastric cardia is effective both in complete resection of the tumor, and clearation of more lymph nodes. The resection rate is higher and the postoperative complications rate is lower. In some way,it＇s better than the left thoracicic incision and the upper abdominal incision.