老年贲门癌经腹及经胸手术切除的对比研究

The retrospective review of the effect of transabdominal and transthoracic surgery approaches to the management of old-age cardic cancer

目的探讨老年贲门癌手术入路的选择。方法对270例分为经胸、经腹手术治疗的贲门癌年龄大于65岁的老年患者的资料进行回顾性分析。结果经腹组较经胸组术前存在更显著的高危因素(P<0.01),但两组术后心肺功能不全发生率、手术切除率、吻合口瘘发生率,吻合口狭窄、手术时间、清扫腹腔淋巴结转移率与经胸组比较差异均无统计学意义。经腹入路切缘癌残留、清扫胸腔内淋巴结、术后疼痛与经胸组比较有统计学意义。结论老年贲门癌手术应选择以经胸微创手术切除为主的手术入路,针对个别情况可选择经腹入路。

Objective To evaluate the surgical approach in old-age cardiac cancer.Methods A retrospective research of 270 cardiac cancer patients age older than 65 was conducted.The data of patients with surgery transthoracic or transabdominal were analyzed.Results Between the two groups,there were differences in the preoperative high risk factors（P0.01）,residual tumor occur at the excision margin,number of thoracic lymph node resected and incidence of pain occurred after surgyer;there was no differences in the incidence of cardiorespiratory insufficiency,anastomotic leakage,anastomotic stenosis,resection rate,and the operation time and number of abdominal lymph node resected.Conclusions The approach of transthoracic incision is better than that of transabdominal incision to radical cardiac cancer in old-age patients.