经腹与经胸进行贲门癌切除治疗对老年贲门癌患者预后的影响分析

Effect of Transthoracic and Transabdominal Resection on Prognosis of Elderly Patients with Cardiac Carcinoma

目的观察老年贲门癌采用经腹贲门癌切除术与经胸贲门癌切除术治疗疗效及对患者预后的影响。方法将94例贲门癌患者按照手术路径不同分为对照组与观察组,各47例。对照组采用经胸贲门癌切除术治疗;观察组采用经腹贲门癌切除术治疗。比较2组清扫淋巴结数目、术后并发症、术后1、3、5年生存率。结果观察组清扫淋巴结数目为(11±6)个,明显高于对照组(7±3)个;且观察组术后并发症明显低于对照组(P<0.05)。2组患者术后1、3、5年生存率、淋巴结阴性3、5年生存率及淋巴结阳性5年生存率比较,无统计学意义(P>0.05);而淋巴结阳性3年生存率试验组明显高于对照组(P<0.05)。结论临床采用经腹贲门癌切除术治疗,患者术后生存率虽与经胸路径切除术治疗无明显差异,但采用经腹贲门癌切除术可提高淋巴结清除,减少术后并发症,因此更具有安全性,值得推广应用。

Objective To observe the efficacy of transabdominal and transthoracic resection for elderly patients with cardiac carcinoma and the prognosis of the patients. Methods 94 cases of gastric cardia cancer according to different surgical paths were divided into the control group and the observation group; each with 47 cases. The control group received transthoracic resection of cardiac carcinoma; the observation group received transabdominal resection of cardiac carcinoma. The number of lymph nodes dissection,postoperative complications,and postoperative 1-,3-,5-year survival rates between the 2 groups were compared.Results The number of lymph nodes dissection in the observation group was( 11 ± 6),which was significantly higher than that of the control group,( 7 ± 3); postoperative complications of the observation group was significantly lower than that of the control group( P < 0. 05). 1-,3-,5-year survival rates,lymph node negative 3-,5-year survival rates and lymph node positive 5-year survival rates between the 2 groups had no statistical significance( P > 0. 05); and lymph node positive 3-year survival rate of the observation group was significantly higher than that of the control group( P < 0. 05). Conclusion Postoperative survival rates of transabdominal and transthoracic resection of cardiac carcinoma has no significant difference. Transabdominal resection of cardiac carcinoma can improve lymph node dissection,reduce postoperative complications,it is more secure,and should be widely applied.