经胸与经腹径路手术治疗老年贲门癌的临床对照研究  

A Clinical Control Study on the Surgical Treatment of Elderly Patients with GastricCardia Cancer by Transthoracic and Transabdominal Approach

作　　者：向毅[1] 彭香[1] 郭小川[1] 杜成华[2] 郑君[2] 何明学 张永川[2] 

机构地区：[1]四川省第四人民医院胸外科,四川成都610016 [2]达州市中心医院,四川达州635000

出　　处：《四川医学》2017年第6期609-611,共3页Sichuan Medical Journal

基　　金：四川省科技厅科研项目(编号:2014SZ0004-5)

摘　　要：目的探讨老年贲门癌手术治疗经胸及经腹入路的优缺点及选择原则。方法回顾性分析78例年龄大于65岁老年贲门癌患者行经胸及经腹径路手术治疗的临床资料。结果经胸组和经腹组的上切缘阳性率分别为4.08%和13.79%,平均淋巴结清除个数分别为9.8和13.2个,两组间比较差异有统计学意义(P<0.05);下切缘阳性率、上下切缘阳性率、并发症发生率、手术根治率、手术后平均恢复时间以及平均生存时间,分别为4.08%和6.89%,2.04%和6.89%,12.24%和10.34%,86.20%和87.75%,11d和9d,(3.5±1.2)和(3.0±2.3)年,两组间比较差异均无统计学意义(P>0.05)。结论应个体化选择老年贲门癌患者手术径路,充分考虑老年患者的病变部位、范围、分期以及呼吸、心血管系统状况。Objective To explore the advantages and disadvantages of surgical treatment of elderly patients with cardiac carcinoma by thoracic and abdominal approach and its selection principle. Methods The clinical data of 78 patients over the age of 65 years with cardiac carcinoma who underwent surgical treatment by thoracic and abdominal approach were retrospectively ana- lyzed. Results The positive rate of the upper incisal margin in the thoracic and abdominal group was respectively 4. 08% and 13.79% ,while the mean clearance number of lymph nodes was respectively 9. 8 and 13.2, and the difference between the two groups was statistically significant（ P 〈 0. 05 ）. The positive rate of the lower incisal margin, positive rate of the upper and lower in- cisal margin, complication rate, surgical cure rate, the average recovery time and the average survival time after surgery were respec- tively 4. 08% and 6. 89% ,2. 04% and 6. 89% , 12. 24% and 10. 34% , 86.20% and 87.75% , 11 and 9 days, （ 3.5 ± 1.2 ） and （3.0 ± 2. 3 ） years, and the differences between the two groups were not statistically significant （ P 〉 0. 05 ）. Conclusion The choice of surgical approach for the elderly patients with gastric cardia cancer should be individualized, taking into account the loca- tion, range, staging, respiratory and cardiovascular status of the elderly patients.

关 键 词：贲门癌 手术治疗 临床对照研究 

分 类 号：R735.2[医药卫生—肿瘤]