2675例贲门癌手术治疗疗效分析

Operative treatment experience in 2675 cases with cardia cancer.

目的 探讨贲门癌的手术入路及吻合方法改进的临床意义。方法 对外科治疗贲门癌 2 675例进行回顾性分析 ,就手术入路途径的临床效果进行讨论 ,并介绍一种改进的吻合方法。结果 切除组 1、3、5、10年生存率分别为 77 5 %、3 7 8%、2 8 2 %和 9 4% ,有 11例 15年健在。经胸骨上腹正中切口入路 3 62例 ,病理证实上切缘均未见癌累及。采用改进的吻合方法施术 485例 ,均未发生吻合口瘘。结论 经胸骨上腹正中切口入路 ,因不进胸腔 ,创伤小 ,尤其适用于高龄或心肺功能较差的患者。改进的吻合方法 ,设计合理 ,不增加新的创伤 。

Objective To investigate the clinical value of the operative approach and an improved anastomosis in cases with cardia cancer. Methods We retrospectively reviewed the data on the surgical treatment of 2675 patients with cardia cancer to discuss the clinic effect of the different operative approach and introduce an improved anastomosis. Results The survival rates of 1-year ?3-year?5-year?10-year for removed group were 77.5%?37.8%?28.2%9.4%. 11cases survived more than 15years ; Approach via sternum and epigastric median incision was performed in 362 cases. 485 cases were performed with the improved anastomosis, in which no one suffered from the anastomotic leakage. Conclusion The operative approach via sternum and epigastric median incision, avoiding invading the thoracic cavity, espetciany is fit for the cardiopulmonary insufficient patients and the eld patients. The improved anastomosis is scientific and effective which does not add the wound.