经腹手术治疗贲门癌155例临床分析

Transabdominal intramediastinal esphagogastrostomy for the treatment of gastric cordial cancer

目的探讨治疗贲门癌的手术入路及吻合方法。方法对155例贲门癌患者经腹切开膈肌脚入路，行胃浆肌瓣覆盖-食管胃黏膜吻合。结果全组病例无死亡、无吻合口漏及食管切缘癌残留。术后并发症发生率5．8％。结论经腹切开膈肌脚，行胃浆肌瓣覆盖．食管胃黏膜吻合术能有效地预防吻合口漏，适用于浸润食管长度〈2cm的贲门癌的手术治疗。

Objective To evaluate a surgical approach and anastomosis for the treatment of carcinoma of the gastric cardia. Methods Transabdominal intramediastinal esophagogastric anastomosis covered by sero-muscular flap of gastricwall for cardial carcinoma in 187 cases. Results The method reached the satisfactory surgical result in terms of tumor free cut edge on esophagus end of the resected samples. And the morbidity rate was 5.8 %. Conclusion The technique enables lymphadenectomy within the lower mediastinum and a sufficiently long enough resection of esophagus. Transabdominal incision of the crus dextrum of the diaphragm makes a clear operative field for the purpose of radical operation for carcinoma of the gastric cardia. The anastomosis effectively prevents anastomotic leakage. This procedure is indicated for cardlal carcinoma cases in which the esophageal involvement is within 2cm.