胸腹联合切口治疗贲门癌106例报告

为了探讨胸腹联合切口在贲门癌手术中的应用价值,回顾性分析采用胸腹联合切口治疗贲门癌106例的临床资料。结果106例手术切除90例(84.9%),其中根治性切除68例(75.6%),姑息性切除22例(24.4%),开腹探查16例(15.1%)。手术死亡1例(0.95%)。术后并发症15例(14.2%),其中肺部并发症9例,心律失常心衰5例,胸腔积液5例,切口感染6例,上切缘癌残留1例(1.1%),下切缘均无癌残留,全组无吻合口瘘。1、3和5年生存率分别为91.5%(66/72)、62.6%(27/44)和38.2%(7/18)。初步研究结果提示,胸腹联合切口治疗贲门癌较单纯经胸或经腹手术径路显露好,有利于肿瘤切除及胸腹部区域淋巴结清除,可提高手术切除率及根治性切除率。

Reports of 106 cases about thoracoabdominal approach in treating cardiac cancer

The objective of this study was to assess the value of thoracoabdominal approach in treating cardiac cancer.A total of 106 cases of thoracoabdominal approach in treating cardiac cancer were retrospectively analysed.Ninety cases of cardiac cancer were removed with a clean rate of 84.9%,of which 68(75.6%)cases got radical clean,22(24.4%)cases got palliatly cleaned,16(15.1%)cases only got checked through openning abdomen.One patient died of the operation,with a death rate of 0.95%,15 patients developed complications,with a rate of 14.2%,of which 9 cases developed lung symptom,5 cases with arrhythmias and heart failure,another 5 cases with pleural cavity fluid,and 6 cases got infection on the cut point.There was 1 case with carcinoma remained on the site of upper cut(1.1%),while none was left on the opposite site.No fistula happened on the suture point.The survival rates of 1-,3-and 5-year after the operation were 91.5%(66/72),62.6%(27/44)and 38.2%(7/18),respectively.In conclusions,the thoracoabdominal approach to treat cardiac cancer is better than solely cut through chest or abdomen.It is benifit for cleaning of carcinoma and lymphote node in the chest and abdomen,which may advance clean rate of operation and radical clean rate.