胃上部癌的经腹外科治疗

Surgical treatment of invasive proximal gastric cancer

目的 提高胃上部癌外科治疗水平。方法 对94例胃上部癌采用了经腹正中切口或合并切除剑突及左第7～9肋弓软骨入路,行近端胃或全胃切除术。结果 全组病例发生吻合口瘘1例,食管断端癌残留3例和肺部感染8例,无肋软骨炎及胸膜损伤所致血气胸发生。结论 胃上部癌经腹入路暴露良好,创伤小,痛苦少,适用于食管无浸润或浸润小于1 cm的胃上部癌的患者。

Objective To introduce the surgical treatment experiences of upper gastric cancer in our department in recent 10 years for improving its therapeutic level. Methods 94 patients with upper gastric cancer underwent proximal subtotal gastrectomy or total incision plus the left seventh to ninth ribs resection. Results One case developed a fistula at the anastomosis, 3 cases had residual tumor cells at the esophageal margin, and 8 cases developed pttlmonary infections. No one developed costal chondritis or hemopneumothorax followed by pleura injury. Conclusions Operations through mid-abdominal incision on patients with upper gastric cancers, which provide a well exposure, less injury and pain, and are applicable to those whose esophageal invasion is under 1 cm of length.