胸腹联合治疗食管胃交界部癌的近期疗效及并发症观察

Recent Curative Effect of Treating Esophagogastric Junction Cancer with Chest and Abdomen Combination Therapy and Observation of Complications

目的：观察胸腹联合治疗食管胃交界部癌的近期疗效及并发症的情况。方法：选取某院2010年1月～2013年7月86例患食管胃交界部癌的患者进行随机分组研究。其中采取胸腹联合治疗的患者43例,采取单纯开腹治疗的患者43例,比较两组患者手术情况、术后疗效以及并发症发生率。结果：两组平均住院时间比较无统计学差异（P〉0.05）;胸腹联合组手术时间（355.25±30.58）min高于单纯开腹组（271.01±14.25）min,两组比较有统计学意义（P〈0.05）。在淋巴结清扫组数、肿瘤距食管残端距离方面,胸腹联合组分别为（35.2±1.59）枚、（4.95±0.25）cm,均优于单纯开腹组（29.5±1.53）枚、（1.06±0.21）cm,两组比较有统计学意义（P〈0.05）。术后并发症的总发生率,胸腹联合组18.6%,显著低于单纯开腹组72.1%,两组比较有统计学意义（P〈0.05）。结论：胸腹联合治疗因手术过程相对复杂,手术时间也相对较长,但对肿瘤的切除更彻底,对淋巴结的清扫组数也更多,术后并发症的发生率较低。术前患者体征监测及评估是手术开展的基本前提,当患者满足开胸手术适应证时应优先采取胸腹联合手术治疗。

Objective：To observe the curative effect of treating esophagogastric junction cancer with chest and abdomen combination therapy and complications.Methods：86 cases of patients suffering from esopha-gogastric junction cancer treated in a hospital from January 2010 to July 2013 were taken as research objects, who were randomly divided into two groups.43 cases in one group were treated with chest and abdomen com-bination therapy,and the other 43 patients were treated with pure open surgery.Then compare surgery, postoperative efficacy and complications of the two groups.Results：The average length of hospital stay of the two groups had no statistical difference （P〉0.05）,operating time of chest and abdomen combination thera-py（355.25±30.58）min is higher than that of the pure open surgery （271.01±14.25）min,and the difference was statistically significant （P〈0.05）.For the lymph node numbers,distance of tumor from the esophageal stump,the chest and abdomen combination therapy group were （35.2±1.59）,（4.95±0.25）cm respectively, were superior to those of the pure open surgery group （29.5±1.53）,（1.06±0.21）cm,and the difference was statistically significant （P〈0.05）.Total incidence of postoperative complications of chest and abdomen combination therapy was 18.6%,significantly lower than that of the pure open surgery group 72.1% ,the difference was statistically significant （P〈0.05）.Conclusion：The process of chest and abdomen combination therapy is relatively complex,operating time is relatively long,but the tumor excision is more complete,the lymph node cleaning number is more,and the incidence of postoperative complications is low.Preoperative monitoring and evaluation of patients＇signs is the basic premise of the surgery.When the condition is satis-fied,chest and abdomen combination therapy should be given primary consideration.