胃底贲门癌经腹手术切除探讨

目的 探讨胃底贲门癌经腹手术的适应症和优缺点及手术技巧。方法 对126例经腹手术的胃底贲门癌及70例经胸手术或胸腹联合手术的胃底贲门痛病例进行回顾性分析。结果 三种不同手术径路均无吻合口瘘，标本经病理证实食管切缘无癌细胞残留。经腹手术者出血量少，术后恢复快，住院时间短，经胸或胸膜联合手术者出血量多，住院时间长，并发症多。结论 胃底贲门癌经腹手术效果好，可避免经胸手术后心肺并发症，有利于腹腔转移性淋巴结的清扫，创伤小，安全性大。只要适应症掌握恰当，熟练掌握手术技巧，就能避免食管切缘癌残留及吻合口瘘的发生。

Discussion that the gastrocardiac carcinoma is excised by the intraperiteanal operation

Objective The pluses and minuses of the indication and operation skill that the gastrocardiac carcinoma is excised by the intraperiteanal operation. Methods Analysed the reviewing to 126 gastrocardiac carcinoma and 70 by intraperiteanal operation by chest operation or the gastrocardiac carcinoma case of uniting the operation of chest and intraperiteanal. Results Three different operation route have no identical mouthfuls of Lou, sample verify by pathology esophagus cut reason have no cancer cell remain. There is little bleeding amount, resume fast after the operation, and hospital stays are short, who through intraperiteanal operation; the bleeding amount of the patient of the operation more through the chest or the chest and intraperiteanal, hospital stays are long, there are many complications. Conclusions The gastrocardiac carcinoma is effectual in operation through the intraperiteanal, can avoid the heart complication after the chest operation , helping the cleaning of abdominal cavity's shifting lymph gland, the wound is little, the security is great. So long as grasp indication appropriately, master operation skill skillfully , can avoid cut edge cancer remaining and identical mouthfuls of emergence of Lou.