不同手术径路治疗贲门癌的对比研究  

Comparison of two surgical approach for cardiac cancer

作　　者：王晓新[1] 李宏芹 陈鸿义[1] 刘桐林[1] 李简[1] 

机构地区：[1]北京大学第一医院胸外科,100034 [2]北京平谷区医院胸外科

出　　处：《中华外科杂志》2005年第19期1262-1264,共3页Chinese Journal of Surgery

摘　　要：目的探讨经胸、经腹手术径路行贲门癌切除术的优缺点及选择原则。方法将160例贲门癌患者分为经腹切口、经左胸切口组,每组80例,行贲门癌手术治疗,比较两组的平均淋巴结清扫数、切缘癌残留率、手术根治率、围手术期病死率、术后并发症发生率、术后平均恢复时间、生存率。结果经腹切口组和经左胸切口组的平均淋巴结清除个数分别为15.7和10.6个,上切缘癌残留率分别为5.0%和1.2%,两组比较差异均有统计学意义(P<0.05);下切缘癌残留率、围手术期病死率、手术根治率、并发症发生率、手术后平均恢复时间、生存率分别为1.2%,0.0%,81.2%,10.0%,10d,53.7%和1.2%,1.2%,83.7%,11.2%,12d,56.2%,两组比较差异均无统计学意义(P>0.05)。结论两种手术切口各有其优缺点,手术切口的选择应重点考虑病变的部位和范围以及患者的身体状况。Objective To explore the preferable surgical approach for cardiac cancer. Methods One hundred and sixty patients with cardiac cancer underwent operation in two surgical approaches （epigastrium and left chest）. Analysis was conducted on lymphnodes resected, stump positive rate, radical resectability rate, perioperative mortality, surgical complication rate, postoperative hospital days, survival rate between the two groups. Results In the epigastrlum group and the left chest group the average number of resected lymphnodes was 15.7 and 10. 6, respectively, the upper stump positive rate was 5.0% and 1.2% , and there was significant difference between the two groups （ P 〈 0. 05 ）. The lower stump positive rate, perioperative mortality, radical resectability rate, surgical complication rate, postoperative hospital days, survival rate of the two groups were 1.2%, 0.0%, 81.2%, 10.0%, l0 d, 53.7% and 1.2%, 1.2% , 83.7% , 11.2% , 12 d, 56. 2% , respectively, and there was no significant difference between the two groups （ P 〉 0. 05 ）. Conclusion There was no difference on the radical respectability rate and 5-year survival rate between the two groups. Thus the surgical approaches for cardiac cancer should based on the location and extent of lesions and the state of paients.

关 键 词：胃肿瘤 消化系统外科手术 治疗结果 贲门癌切除术 手术径路 手术治疗 并发症发生率 经腹切口 左胸切口 围手术期 

分 类 号：R735.2[医药卫生—肿瘤]