左胸路径Sweet术式治疗胃食管交界处Siewert Ⅱ型腺癌效果评价

Evaluation of the Left Chest Path Sweet Operation for the Treatment of Siewert TypeⅡAdenocarcinoma at the Gastroesophageal Junction

目的:分析左胸路径Sweet手术方式治疗胃食管交界处SiewertⅡ型腺癌的外科治疗结果,探讨胃食管交界处腺癌的治疗方式。方法:回顾性分析胃食管交界处SiewertⅡ型腺癌83例患者临床资料,统计分析围术期结果和远期肿瘤学生存结果。结果:83例患者平均手术时间(169.11±31.64) min,术中出血量(229.42±92.02) mL,平均术后住院时间(15.33±9.81) d,术后并发症发生率19.28%,R0切除率96.39%,5年总体生存率37.41%。pN0与pN+患者5年总体生存率分别为65.41%和13.82%,2组间差异有统计学意义(P<0.05)。伴有淋巴结转移的pN+患者,接受单纯手术与手术联合术后辅助放化疗的患者3年总体生存率分别为18.32%和44.91%,差异有统计学意义(P<0.05)。结论:胃食管交界处SiewertⅡ型腺癌采用左胸路径Sweet术式安全可行,术后辅助放化疗能够提高淋巴结转移患者的总体生存率。

Objective:To analyze the results of surgical treatment of Siewert typeⅡadenocarcinoma at the gastroesophageal junction with the left chest approach Sweet surgery in our hospital,and explore the treatment of adenocarcinoma at the gastroesophageal junction.Methods:The clinical data of patients with Siewert typeⅡadenocarcinoma at the gastroesophageal junction treated were collected retrospectively,and the perioperative results and long-term tumor student outcomes were statistically analyzed.Results:A total of 83 patients were included in this study.The average operation time was(169.11±31.64)minutes,the intraoperative blood loss was(229.42±92.02)mL,the average postoperative hospital stay was(15.33±9.81)days,the postoperative complication rate was 19.28%,the R0 resection rate was 96.39%.The 5-year overall survival rate was 37.41%.The 5-year overall survival rates of pN0 and pN+patients were 65.41%and 13.82%,respectively,and the difference between the two groups was statistically significant(P<0.05).For pN+patients with lymph node metastasis,the 3-year overall survival rates of patients who received surgery alone and surgery combined with postoperative adjuvant radiotherapy and chemotherapy were 18.32%and 44.91%,respectively,with statistically significant differences(P<0.05).Conclusion:For the Siewert typeⅡadenocarcinoma at the gastroesophageal junction,the left chest route Sweet operation is safe and feasible,and postoperative adjuvant chemoradiation can improve the overall survival rate of patients with lymph node metastasis.