经胸与经腹贲门癌根治术临床分析

Clinical analysis of radical resection of gastric cardia cancer

目的比较经胸与经腹贲门癌根治术的疗效。方法选取111例接受手术治疗的贲门癌患者,根据手术入路不同分为经胸组(66例)和经腹组(45例)。回顾性分析患者的临床资料。结果 2组的手术时间、术中出血量、手术切除率、围手术期病死率、消化道并发症及3 a生存率比较,差异无统计学意义(P>0.05)。经胸组住院时间、淋巴结清扫个数少于经腹组,术后肺部感染率高于经腹组(P<0.05);经腹组的切缘阳性率、吻合口复发率高于经胸组(P<0.05)。差异均有统计学意义。结论经胸与经腹入路贲门癌根治术各有优劣势,应根据患者的具体病情个体化进行选择。

Objective Comparison of curative effect of radical resection of thoracic and abdominal cardia cancer. Methods Totally111 patients with cardiac carcinoma who underwent surgical treatment were divided into two groups according to the surgical approach. The patients were divided into trans thoracic group（ n = 66） and transabdominal group（ n = 45）. The clinical data were analyzed retrospectively.Results 2 groups of operation time,intraoperative blood loss,surgical resection rate,perioperative mortality,gastrointestinal complications and3 year survival rate comparison,the difference was not statistically significant（ P〉0. 05）. Transthoracic group hospitalization time,lymph node number less than the transabdominal group,the abdominal group was higher than that of pulmonary infection after operation（ P〈0. 05）; the positive rate of abdominal margin group,anastomotic recurrence rate is higher than the transthoracic group（ P〈0. 05）. The differences were statistically significant. Conclusion There are advantages and disadvantages of radical resection of carcinoma of stomach by transthoracic and transabdominal approach.