经胸与经腹方式行责门癌根治术的效果分析  

Effect of radical resection of gastric cardia carcinoma via transthoracic and transabdominal approach

作　　者：柏启州[1] 于珺[1] 苟云久[1] 贺生亮[1] BAI Qizhou;YU Jun;GOU Yunjiu;HE Shengliang(Department of Thoracic Surgery,Gansu Provincial Hospital,Lanzhou 730000,Gansu,China)

机构地区：[1]甘肃省人民医院胸外科,兰州7300000

出　　处：《癌症进展》2019年第7期820-822,826,共4页Oncology Progress

摘　　要：目的探讨经胸与经腹方式行贲门癌根治术的临床疗效。方法收集92例贲门癌患者的病历资料,根据手术入路方式分为经胸组(49例)和经腹组(43例),比较两组患者的手术相关指标、术后恢复指标、术后并发症发生率及生存情况。结果经腹组患者手术时间、术中出血量均少于经胸组,淋巴结清扫数目、腹腔淋巴结清扫数目均多于经胸组,差异均有统计学意义(P﹤0.05);两组患者切口长度、胸腔淋巴结清扫数目、切缘肿瘤残留率、手术根治率比较,差异均无统计学意义(P﹥0.05)。经腹组患者术后引流量和住院费用均少于经胸组,住院时间短于经胸组,肺部感染发生率低于经胸组,差异均有统计学意义(P﹤0.05);两组患者术后胸腔积液、腹腔感染、切口感染、吻合口瘘发生率比较,差异均无统计学意义(P﹥0.05)。两组患者术后生存情况比较,差异无统计学意义(P﹥0.05)。结论经腹入路相对经胸入路行贲门癌根治术具有淋巴结清扫更为彻底,术后恢复快,住院时间短,肺部感染发生率低的优势,值得在临床中进一步推广应用。Objective To investigate the clinical efficacy of radical resection of gastric cardia carcinoma via transthoracic and transabdominal approach.Method The clinical data of 92 patients with gastric cardia carcinoma were collected. According to the operative approach,these patients were stratified as transthoracic surgery group (n=49) and transabdominal surgery group (n=43),the surgery-related measures,postoperative recovery indicators,postoperative complication rate,and survival between the two groups were compared.Result The operative time,intraoperative blood loss in the transabdominal surgery group were significantly less than those in the transthoracic surgery group,and number of resected lymph nodes number of resected abdominal lymph nodes were more than that in the transthoracic surgery group (P<0.05);while there were no significant differences in the length of incisions,number of resected thoracic lymph nodes, rate of residual positive margin,and radical resection rate between the two groups (P>0.05).The postoperative drainage volume and hospitalization expenses were less,and the hospital stay was shorter,and the incidence rate of pulmonary infection was lower in transabdominal surgery group than those in the transthoracic surgery group (P<0.05);the incidence rate of postoperative pleural effusion,intraabdominal infection,incision infection and anastomotic leakage did not differ significantly between the two groups (P>0.05).There was no significant differences in the survival between the two groups (P>0.05).Conclusion Compared with transthoracic approach,radical resection of gastric cardia carcinoma via transabdominal approach is an advantageous procedure with more extensive lymph node dissection,quicker postoperative recovery,shorter duration of hospitalization,and decreased pulmonary infection rate,which is valuable to be applied in clinical.

关 键 词：贲门癌 经胸入路 经腹入路 根治术 

分 类 号：R735.2[医药卫生—肿瘤]