论文部分内容阅读
目的:探讨不同手术入路在贲门癌治疗中的临床应用。方法:回顾性分析我院2003年8月至2009年1月期间收治的153例贲门癌患者的临床资料,根据不同手术入路分为经腹组(n=74)、胸腹联合组(n=27)和经胸组(n=52),对3组患者的手术中、术后恢复情况以及随访结果进行对比分析。结果:手术切除率100%,围手术期无死亡病例。经腹组手术时间短于经胸组和胸腹联合组,术中出血量也少于经胸组和胸腹联合组,但差异无统计学意义(P>0.05)。胸腹联合组和经腹组清扫的淋巴结数目明显多于经胸组,差异有统计学意义(P<0.05)。经腹组患者术后住院时间和术后并发症发生率明显少于胸腹联合组和经胸组,差异有统计学意义(P<0.05)。3组患者的术后局部复发率和远处转移率的差异均无统计学意义(P>0.05),3年和5年生存率的差异也无统计学意义(P>0.05)。结论:经腹贲门癌切除术是安全和有效的,配合吻合器的使用,操作也是可行的。
Objective: To investigate the clinical application of different surgical approaches in the treatment of cardia cancer. Methods: The clinical data of 153 patients with cardia cancer who were treated in our hospital from August 2003 to January 2009 were retrospectively analyzed. According to different surgical approaches, they were divided into transabdominal group (n = 74), thoracoabdominal group (n = 27) and transthoracic group (n = 52). The operative, postoperative recovery and follow-up results of three groups of patients were compared. Results: Surgical resection rate of 100%, no perioperative deaths. The operation time of transabdominal group was shorter than that of combined group of thoracic and thoracoabdominal. The amount of bleeding during operation was also less than that of combined group of thoracic and thoracoabdominal, but the difference was not statistically significant (P> 0.05). The number of lymph nodes dissected in thoracoabdominal group and transabdominal group was significantly more than that in transthoracic group, with significant difference (P <0.05). The incidence of postoperative hospital stay and postoperative complications in the transabdominal group was significantly less than that in the thoracoabdominal group and the transthoracic group, with significant difference (P <0.05). No significant difference was found in the local recurrence rate and distant metastasis rate between the three groups (P> 0.05). There was also no significant difference in the 3-year and 5-year survival rates (P> 0.05). Conclusion: Transabdominal cardia cancer resection is safe and effective, with the use of stapler, the operation is feasible.