贲门癌手术径路与疗效分析

Analyses of Surgical Approaches and the Efficacy on Gastric Cardiac Carcinoma

目的探讨贲门癌最佳手术径路。方法回顾性分析342例贲门癌临床资料,统计3种手术径路的切缘癌残留率、平均清扫淋巴结数目、5年生存率、吻合口瘘发生率、心肺并发症发生率和术后平均住院时间等指标。结果 3种手术径路的切缘癌残留率、平均清扫淋巴结数目、5年生存率、吻合口瘘发生率比较差异无统计学意义(P>0.05),经腹手术与经胸和经胸腹联合手术相比,心肺并发症发生率和术后平均住院时间差异有统计学意义(P<0.05)。结论 3种手术径路各有优缺点,选择何种手术径路要根据患者具体情况决定。病情允许,经腹为首选。

Objective To explore the option surgical approach for the cardiac carcinoma.Methods The clinical data of 342 patients were analyzed retrospectively.The residual incisionmargin cancer rate of three surgical approaches,the number of average cleaned lymph nodes,the 5-year survival rate,the incidence of anastomotic leakage,the incidence of the heart and lung complications and the average postoperative hospital stay were statistically analyzed.Results In the three groups,there was no difference among the residual incisionmargin cancer rate,the number of average cleaned lymph nodes,the 5-year survival rate,and the incidence of anastomotic leakage（P〉0.05）,but there was a significant difference between transabdominal approach group and thoracic and thoracoabdominal approach group in the incidence of the heart and lung complications and the average postoperative hospital stay（P〈0.05）.Conclusion The three surgical approaches have their own merits and deficiencies.An appropriate choice for the surgical approach of cardiac cancer should be made based on the characteristics of the patient.Abdominal incision is the best choice if the condition is allowed.