1924例食管癌和贲门癌的外科治疗经验  

Surgical experience of esophageal and gastric cardial carcinoma: an analysis of 1924 cases

作　　者：熊刚[1] 邱阳[1] 杨康[1] 李军[1] 廖克龙[1] 王明荣[1] 曾会昌[1] 张伟[1] 王海东[1] 

机构地区：[1]第三军医大学西南医院胸心外科,重庆400038

出　　处：《重庆医学》2008年第4期342-344,共3页Chongqing medicine

摘　　要：目的总结1924例食管癌和贲门癌的外科治疗经验。方法分析1990～2006年1924例食管癌和贲门癌外科手术患者的临床资料。将患者按时间段分为两组进行比较，1990年1月～1998年12月的624例患者为甲组，1999年1月～2006年12月的1300例患者为乙组。结果全组患者总的肿瘤切除率为92．67％，食管癌和贲门癌的切除率分别为93．75％和89．02％，其中甲、乙两组患者的切除率分别为90．54％和93．69％；总的围术期死亡率为1．46％，甲、乙两组分别为2．56％和0．85％；总的胸内吻合口瘘和胸胃瘘的发生率为2．23％，甲、乙两组分别为3．80％和1．55％；总的5年生存率为23．64％，其中食管癌为26．35％，贲门癌为18．47％。结论食管、贲门癌总的治疗效果没有明显的改善，但手术适应证已明显拓宽，机械吻合的广泛应用显著降低了吻合口瘘的发生。早诊断、早治疗是该病治疗的关键。Objective To evaluate and summarize the experience of surgical treatment for esophageal and gastric cardial carcinoma. Methods A retrospecive analysis was compiled of 1 924 surgically treated patients with esophageal carcinoma or gastric cardial carcinoma between January 1990 to December 2006. The patients were divided into A and B groups： 624 patients（group A） were treated surgically in the first 9 years,1300 patients（group B） in the next 8 years. Results The overall resection rate was 92.67%, the rate of esophageal and cardial carcinoma was 93.75% and 89.02% respectively（P=0. 015）. The overall hospital mortality was 1.46 %;it was 2.56 % for group A,0.85 % for group B（P= 0. 006）. The incidence of intrathoracic anastomotic leakage and thoracic gastric leakage occurred in 33 patients with an overall incidence of 2.23 %;the incidence of group A and group B was 3.80% and 1.55 %, respectively（P=0.011）. The overall 5-year survival was 23.64 %. The 5-year survival for esophageal and cardial carcinoma was 26.35 % and 18.47% respectively. Conclusion The results of treatment approach for esophageal and gastric cardial carcinoma is still unsatisfactory. The indications for surgical treatment have been extended greatly. And the using of circular staplers in esophagogastroanastomosis reduced the incidence of leakage markedly. Early diagnosis and proper treatment is the key for getting a good outcome.

关 键 词：食管癌 贲门癌 外科手术 

分 类 号：R735[医药卫生—肿瘤]