经胸与经腹贲门癌根治术的临床对照分析

A comparative analysis of radical surgery for gastric cardiac cancer via trans-thoracic and trans-abdominal approach

目的探讨经胸及经腹贲门癌根治术的优缺点及选择原则。方法回顾性分析93例行经胸及经腹贲门癌根治术的贲门癌患者的临床资料。结果经胸组淋巴结清扫个数大于经腹组,差异有统计学意义;经胸组上、下切缘癌残留率虽低于经腹组,但差异无统计学意义。经胸组术后呼吸系统并发症发生率高于经腹组,但差异无统计学意义。经胸组术后反流性食管炎和吻合口狭窄发生率显著低于经腹组。结论经胸及经腹贲门癌根治术各有优缺点,应根据患者的年龄、身体状况、肿瘤侵犯部位等合理选择手术入路。

Objective To explore the advantages,disadvantages and selection principles of trans-thoracic and trans-abdominal surgical approaches for gastric cardiac cancer.Methods The clinical data of 93 patients receiving radical surgery for gastric cardiac cancer via trans-thoracic and trans-abdominal surgical approaches were analyzed retrospectively.Results The number of resected lymph nodes was larger in trans-thoracic group than in trans-abdominal group.The positivity rate of residual cancer at the upper and lower cutting edge was lower in trans-thoracic group than in trans-abdominal group,but there was no statistical difference.The rate of respiratory complications was higher in trans-thoracic group than in trans-abdominal group,but there was no statistical difference.The rate of reflux esophagitis and anastomotic stricture was obviously lower in trans-thoracic group than in trans-abdominal group.Conclusion The trans-thoracic and trans-abdominal surgical approaches for gastric cardiac cancer have respective advantages and disadvantages.The selection principle should be based on age,physical conditions and site of tumor lesion.