胃上部癌具有向食道下段浸润和腹腔淋巴结转移为主的特点。经典的手术采取经胸腹联合切口行根治性全胃切除术,手术创伤较大,并发症较多。近年来,由于经腹手术方法的改进,吻合器的广泛应用,有些学者主张对胃上部癌浸润食道1～2cm以下,可采取经腹根治性全胃切除术。我科3年来对202例胃上部癌施行了经腹根治性全胃切除术,食道切缘癌残留35例,发生率17.5%。报告如下。 1 资料和方法连续收集1991～1994年经腹手术根治胃上部癌202例。男166例,女36例。年龄24～74岁,平均57岁。术前胃镜和胃肠钡餐检查取得胃癌的定位,定性诊 Upper stomach cancer is characterized by infiltration of the lower esophagus and lymph node metastasis. In the classic surgery, radical abdominal total gastrectomy was performed using a combined thoracoabdominal incision. The surgical trauma was large and there were many complications. In recent years, due to the improvement of transabdominal surgical methods and the wide application of staplers, some scholars have advocated that the upper stomach infiltrate the esophagus below 1-2cm, and radical total gastrectomy can be performed. In the past three years, our department has performed radical abdominal gastrectomy on 202 cases of upper stomach cancer. There are 35 cases of residual cancer in the esophagus and the incidence rate is 17.5%. The report is as follows. 1 Materials and Methods Continuous collection of 202 cases of upper stomach cancer was performed by abdominal surgery from 1991 to 1994. There were 166 males and 36 females. Age 24-74 years old, average 57 years old. Preoperative Gastroscopy and Gastrointestinal Barium Measure for Localization of Gastric Cancer and Qualitative Diagnosis