老年患者经胸和经腹贲门癌根治术的临床效果及安全性差异

CLINICAL EFFECT AND SAFETY OF THE THORACIC AND ABDOMINAL RADICAL RESECTION FOR ELDERLY PATIENTS WITH CARDIA CANCER

目的探究老年患者经胸和经腹贲门癌根治术的临床效果及安全性差异,并为该病最优化治疗积累经验。方法选取收治的56例贲门癌患者,利用随机数字表法进行分组,分别设为观察组和对照组,每组各28例。其中对照组开展经胸入路肿瘤切除术,观察组则实施经腹入路肿瘤切除术。记录二组患者术后1、3年生存率及并发症发生率,并做好对比。结果观察组肺部并发症发生率低于对照组(P<0.05),膈下腹腔感染、残留癌及吻合口瘘发生率差异无统计学意义(P>0.05)。二组1年和3年生存率差异无统计学意义(P>0.05);二组淋巴结阴性者的3年生存率差异无统计学意义(P>0.05),观察组淋巴结阳性3年生存率高于对照组(P<0.05)。结论对于老年贲门癌患者而言,开展经腹贲门癌根治术相比于经胸入路术式,能提高淋巴结阳性者生存率,并降低肺内并发症发生率,值得在临床上进一步推广。

Objective To explore the clinical effect and safety after thoracic and abdominal radical resection of ear^tiac carcinoma, and to cumulate optimal treatment experience. Methods A total of 56 patients with cardiac carcinoma surgery were selected in author＇s hospital from March 2009 to March 2011, by randomly grouping, they were divided into study group and control group, 28 cases in each group. The control group carried out transthoracic approach for resection of the tumor, the study group was implemented the transabdominal approach for resection of the tumor. Recorded and compared the survival rate, the incidence of complications in two groups of patients after 1 year, 3 years. Results Pulmonary complication rate of the study group was higher than the control group （P〈0.05）, but subphrenic infection, residual cancer and the incidence of anastomotic leak had no significant difference between the two groups（P〈0.05）. Survival rate was no statistically significant between the two groups after 1 year and 3 year（P〈0.05）, survival rate of lymph node negative patients was slso no significant difference between the two groups after 3 year （P〈0.05）, but it was higher than the control group in patients with positive lymph nodes after 3 years （P〈0. 05）. Conclusions For elderly patients with cardia carcinoma, development of transabdominal radical resection of cardiac carcinoma compared with transthoracic approach procedure, can improve the survival rate of positive lymph nodes, and reduce the incidence of pulmonary complications, it is worthy of further promotion in clinical.