食管胃结合部腺癌根治手术食管安全切缘距离的研究  

Study on the safety margin of esphagus in the radical gastrectomy of adenocarcionma of esophagogastric junction

作　　者：弥海宁[1] 李兴文[1] 杨荣[2] 杨言苹[3] 王涛[1] Mi Haining Li Xingwen Yang rong Yang Yanping Wang Tao(Gastrointestinal Oncology Surgery Department, Tumor Hospital of Gansu Province ,Lanzhou 730050, Chin)

机构地区：[1]甘肃省肿瘤医院胃肠外科,兰州730050 [2]甘肃省肿瘤医院病理科,兰州730050 [3]甘肃中医药大学附属医院麻醉科

出　　处：《中国综合临床》2017年第4期308-311,共4页Clinical Medicine of China

基　　金：2014年甘肃省卫生行业科研计划项目（GSWSKY2014-15）

摘　　要：目的 探讨食管胃结合部腺癌根治术中最小食管安全切缘距离的判定.方法 通过对50例施行经腹根治性手术的食管胃结合部腺癌通过测量术中、术后及病理大切片上显微镜下食管切缘的距离及肿瘤向食管浸润的距离并分析其与临床病理因素的关系,判断最小安全切缘距离.结果 50例患者中46例向食管近侧浸润,浸润的最短距离为0.1 cm,最长距离为3.5 cm,其中〈1.0 cm11例,19例（41.3%）浸润距离在1.0~1.5 cm范围内,15例在1.5~3.0 cm之间,只有1例浸润最长达3.5 cm.浸润距离与病理因素密切相关（P〈0.001）.结论 对于食管胃结合部腺癌（SiewertⅡ型、Ⅲ型）经腹切除食管最小安全切缘为3.5 cm.Objective To discuss decision of the safety margin of esophagus in the radical gastrectomy of adenocarcionma of esophagogastric junction.Methods The length of esophageal resection margin of intraoperative,postoperative and pathological large slice under the microscope of 50 cases adenocarcionma of esophagogastric junction underwent radical gastrectomy were measured,and the proximal invasive length of esophagus in large pathological slice were also measured,and the relationship between it and pathological factors was analyzed.Determined the minimum safety cut edge distance.Results In 46 of 50 patients,proximal intramural spread of the tumor was observed.The invasive length of tumor from 0.1 cm to 3.5 cm.The invasive length of tumor was 〈1.0 cm with 11 patients,1.0-1.5 cm with 19 patients,1.5-3.0 cm with 15 patients,in only 1 patient was the distance of spread 3.5 cm.Invasive length of adenocarcionma of esophagogastric junction had a significant difference between the groups in different pathological factors（P〈0.001）.Conclusion The length of 3.5 cm is the safety margin of esophagus in the radical gastrectomy of adenocarcionma of esophagogastric junction（SiewertⅡ,Ⅲ type） by abdominal incision.

关 键 词：食管胃结合部腺癌 手术 浸润距离 

分 类 号：R735[医药卫生—肿瘤]