贲门癌手术入路的选择

目的:探讨贲门癌手术入路的最佳方法。方法:回顾性分析122例贲门癌经腹切口,经左胸切口,经胸腹联合切口手术的临床资料。按不同手术入路分为经腹组和经胸组,比较两组的平均手术时间,术中出血量,术后平均住院时间,平均清扫淋巴结数,上切缘癌阳性率,吻合口瘘发生率,心肺并发症发生率。结果:两组的平均清扫淋巴结数,上切缘癌残留率,吻合口瘘发生率比较差异无统计学意义(P>0.05)。经腹者手术时间短,术中出血少,术后恢复快,心肺并发症少。结论:贲门癌术前需认真分析病情,合理选择手术入路,病情允许者经腹为首选。

Operative Approach Selection of Carcinoma of Gastric Cardia

Objective:To discuss the best operative approach selection of carcinoma of gastric cardia.Methods:We analyzed clinical data of 122 cases cardia carcinoma through abdominal incision,through left thoracic incision and through abdominothoracic incision.All cases were divided into transabdominal group and transthoracic group,compare the average surgical operation time,the bleed quantity in the surgical operation,average hospitalization time after the operation,the average number,the lymphoglandulae be cleaned up,presence of residual tumor at the excision margin,the rate of the anastomotic leakage,the incidence rate of the heart and lung complication of two groups.Results:The average number the lymphoglandulae be cleaned up,presence of residual tumor at the excision margin and the rate of the anastomotic leakage of two groups is similar.The disparity did not have statistics meaning(P>0.05).The time in operation of transabdominal group is short,bleed in the operation is little,recovery phase is short,the heart and lung complications is fewer.Conclusion:Cardia carcinoma surgical operation needs the earnest analysis condition before,select reasonable operative approach.abdominal incision is the best choice if the condition is allowed.