全胃切除术治疗贲门癌疗效分析

目的：探讨贲门癌的手术方式。方法：全胃、脾及胰部份切除69例、单纯全胃切除10例。其中71例经左侧胸腹联合切口完成手术，8例经腹部切口完成手术。消化道重建以空肠远近端侧侧吻合代胃。结果：术后死亡５例，病死率6.3%。吻合口瘘4例，切口感染3例，脓胸2例，术后并 发症发生率11．3％。生存满5年者7例，5年生存率8．8％。结论：对贲门癌患者经左侧胸腹联合切合作全胃切除有利于彻底清扫转移淋巴结，避免上切端癌肿残留、 减少吻合口瘘。消化道重建以空肠远近端侧侧吻合代胃可减少反流性食管炎症状。

The choice of total gastrectomy mode in the treatment of gastric cancers

Objective To discuss on the choice of total gastrectomy mode in the treatment of gastric cardiac cancers.Methods The analysis consists of 79 cases of gastric cardiac cancers,among them extended brunshwig total gastrectomy was done in 69 patients,single total gastrectomy in 10,thoracoabdominal approach in 71 and abdominal approach in 8.Braum enterostomy gastrectic replacement was undergone in the whole patients.Results 5 deaths resulted in a mortality of 6.3%.4 anastomotic fistulae,3 wound infections and 2 emphyemas resulted in a total complication rate of 11.3%.7 patients survived more than 5 years.Conclusion It is concluded that thoracoabdominal approach gives a wilds operative field necessitated in the thorough cleaning of the regional lymph modes and the anastomotic accident is accordingly reduced.Braum entersotomy gastroplasty is useful in the prevention of regurgiation oesophagitis.