经胸与经腹切除术对贲门癌患者临床疗效的比较研究

Clinical Observation of Transthoracic and Transabdominal Resection on Prognosis of Patients with Cardiac Carcinoma

目的比较贲门癌患者采用经胸贲门癌切除术与经腹贲门癌切除术治疗的疗效及预后。方法 2008年1月至2011年10月,甘肃省人民医院收治的行贲门癌手术患者200例,其中胸外科手术治疗137例(经胸组),普外科手术治疗63例(经腹组)。对两组患者的临床资料、术后并发症和术后5年生存率进行比较。结果经胸组清扫淋巴结数目明显高于经腹组,两组比较差异有统计学意义(P<0.05)。经胸组平均住院费及吻合口瘘发生率少于经腹组,两组比较差异有统计学意义(P<0.05)。患者术后5年生存率经胸组高于经腹组,两组比较差异有统计学意义(P<0.05)。结论与经腹组相比,临床采用经胸贲门癌切除术治疗,可增加淋巴结清扫数目,降低术后吻合口瘘发生率,减少患者住院费用,增加患者5年生存率,值得临床应用。

Objective To observe the efficacy of transthoracic and transabdominal resection for patients with cardiac carcinoma and the prognosis of the patients.Methods From January 2008 to October 2011 in Gansu Provincial Hospital,200 patients with cardiac carcinoma undergoing radical resection were admitted to the study according to different surgical paths.The Department of Thoracic Surgery （the transthoracic group）received 137 cases while the Department of General Surgery （the transabdominal group） received 63 cases.The clinical features,postoperative complications and 5-year survival rate between the two groups were compared.Results The number of lymph nodes dissection in the transthoracic group was significantly higher than that of the transabdominal group （P〈0.05）.The rate of postoperative anastomotic leakage and the cost of the transthoracic group was significantly lower than that of the transabdominal group （P〈0.05）.The 5-year survival rate of the transthoracic group was significantly higher than that of the transabdominal group （P〈0.05）.Conclusions Compared with the transabdominal group,transthoracic resection of cardiac carcinoma can improve lymph node dissection,reduce the rate of postoperative anastomotic leakage and the cost of the patients and enhance the 5-year survival rate of the patients,which should be worthy of clinical application.