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目的探讨不同手术入路治疗食管癌贲门癌的临床疗效,并对其进行比较。方法 2009年06月至2011年06月期间,我院实施150例食管癌贲门癌手术,对其病例进行回顾性分析。结果 140例患者于左胸后外侧,做一切口开胸,进行食管癌贲门癌根治术,其中进行110例为颈部吻合术(78.6%),14例为弓上吻合术(10.0%),16例为弓下吻合术(11.4%)。术后出现肺部并发症(5例)、颈部吻合口瘘(3例),但经过保守治疗后,均治愈出院。2例于右胸后外侧、腹部正中,做二个切口,进行食管癌根治术;1例于右胸、腹部正中、颈部,做三个切口,进行食管癌根治术;7例于上腹部正中,做一切口,进行贲门癌根治术,术后并发症经过积极的保守治疗,患者均治愈出院。结论根据患者的不同病情,掌握不同入路的适应证,选取恰当的手术入路方式,是治疗成功的关键。
Objective To investigate the clinical effects of different surgical approaches in the treatment of esophageal and gastric cardia cancer and to compare them. Methods From June 2009 to June 2011, 150 cases of esophageal and gastric cardia carcinoma were performed in our hospital, and their cases were retrospectively analyzed. Results One hundred and thirteen patients (110 cases) underwent neck anastomosis (78.6%), 14 cases underwent maxillary anastomosis (10.0%) underwent thoracotomy, 16 cases under the arch anastomosis (11.4%). Postoperative pulmonary complications (5 cases), neck anastomotic fistula (3 cases), but after conservative treatment, were cured. 2 cases of right thoracic outside the middle of the abdomen, do two incisions for radical resection of esophageal cancer; 1 case of the right chest, the middle of the abdomen, neck, do three incisions, radical resection of esophageal cancer; 7 cases of upper abdomen In the middle, do all the mouth, for cardia cancer radical surgery, postoperative complications after active conservative treatment, patients were cured and discharged. Conclusion According to the patient’s different conditions, to grasp the indications of different approaches, select the appropriate surgical approach is the key to the success of treatment.