胃食管交界癌不同手术入路比较分析

目的: 比较胃-食管交界癌不同入路优缺点,探讨不同手术入路的选择方法。 方法: 对蚌埠医学院第一附属医院2006年6月～2007年7月间胃-食管交界处癌95例患者临床治疗进行回顾性分析,详细记录各手术入路组0.0患06)者,的但临术床后指心标肺并,并发行症统的计几分率析低比于较另。两结种果入:路经(腹P=入0.0路61术),前上严切重缘合阳并性症者显4例著(高12于.1%经)左,高胸于组胸和腹胸联腹合联组合(组9.(5%P)=和经左胸组(0)。手术时间与经左胸径路相似,但显著低于经胸腹联合入路(P<0.001)。经左胸入路下切缘阳性率为7.3%(3/41),下纵隔淋巴结清扫与经腹入路组及经胸腹联合入路组相比有统计学差异(P<0.001),经左胸、胸腹联合及经腹入路检出下纵隔淋巴结阳性率分别为41.5%、23.8%、3.0%(P=0.001)。 结论: 对于心肺功能耐受进胸手术者,左胸入路多能满足病变切除范围及常规淋巴结清扫的需要。对于高龄、心肺功能下降患者应尽量避免胸腹联合入路。对于需行全胃切除或联合脏器切除的患者,Ⅲ型者可先进腹探查,根据探查情况选择是经腹还是经胸腹联合入路,Ⅰ、Ⅱ型者应直接使用胸腹联合入路。

Comparison and Analysis of Surgical Approaches for Gastro-esophageal Junction Carcinoma

Objective:To compare and analyze the advantages and shortcomings of different surgical approaches for gastroesophageal junction carcinoma and to explore the optimal surgical approach to treat gastroesophageal junction carcinoma.Methods:We retrospectively analyzed the data of 95 cases of gastroesophageal junction carcinoma seen in our hospital between June 2006 and July 2007.Results:The incidence of preoperative complications were significantly higher in the group treated with transabdominal surgery than in ...