经胸、经腹贲门癌根治术的优劣势分析

目的 探讨经胸和经腹贲门癌根治术的优劣势.方法 分析于2003至2010年术前评估后选择经胸和经腹贲门癌根治术53例患者的术后淋巴结转移分析、术后并发症及生存期探讨经胸及经腹贲门癌根治术的优劣.结果 两组手术均无死亡病例、无吻合口瘘.经腹组切缘阳性1例,后经 放射治疗随访3年无复发,经腹组无中转手术改胸腹联合.经胸组术后无并发血气胸.开始后续治疗的时间或出院时间≤14 d,常见并发症差异无统计学意义,全部随访1年、2年、3年生存率差异均无统计学意义.结论 术前准确评估后,选择性采用经胸或经腹贲门癌根治术,患者术后复发转移率和生存率无差异.经腹手术可避免开胸并发症,特别是对不能耐受开胸手术的患者提供了手术机会.

Advantages and disadvantages of thoracic and abdominal radical operation for cardia cancer

Objective To explore the advantages and disadvantages of thoracic and abdominal radical operation for cardia cancer.Methods The advantages and diadvantages of thoracic and abdominal radical operation for cardia cancer chosen after pre-operation evaluation in 53 patients were explored analyzing lymph node metastasis,postoperative complications and survival periods.Results Among all patients,no case died or occurred anastomotic fistula.1 case of abdominal group was positive in cut edge,but 3-year follow-up showed that this case hadn＆#39; t recurred after radiotherapy.No case had to be transitted to thoracic and abdominal combination operation in the abdominal group.No case of the thoracic group occurred hemopneumothorax.There were statistical differences in subsequent treatment starting time or discharge time ≤ 14 d,common complications and 1,2,and 3 years survival rate between the 2 groups.Conclusions There are no statistical differences postoperative recurrence rate and survival rate between thoracic and abdominal surgery chosen according to accurate preoperative evaluation.Abdominal surgery can avoid thoracic complications and is suitable for patients who can＆#39; t stand thoracic surgery.