经胸入路与经腹入路手术治疗SiewertⅡ型食管胃结合部腺癌的临床疗效观察  

Clinical observation of transthoracic and transabdominal approaches of SiewertⅡadenocarcinoma of esophagogastric junction

作　　者：田德福 衣舜 刘丰芹 TIAN De-fu;YI Shun;LIU Feng-qin(Department of General Surgery,the Fourth People s Hospital of Shaanxi,Xi an 710043,Shaanxi;Department of Thoracic Surgery,Qingdao Municipal Hospital,Qingdao 266000;Department of Facial Features,Dongying District People s Hospital,Dongying 257000,Shandong,China)

机构地区：[1]陕西省第四人民医院普外科,陕西西安710043 [2]青岛市市立医院胸外科,山东青岛266000 [3]东营区人民医院五官科,山东东营257000

出　　处：《川北医学院学报》2021年第11期1484-1487,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨经胸入路与经腹入路手术治疗SiewertⅡ型食管胃结合部腺癌(AEG)的临床疗效观察。方法:对96例SiewertⅡ型AEG患者进行回顾性分析,根据手术入路方式不同分为两组,其中经胸组62例(经左胸入路行AEG根治术治疗),经腹组34例(经腹膈肌食管裂孔入路行AEG根治术治疗)。比较两组淋巴结清扫数目、术后恢复及生存情况。结果:经胸组手术时间、术中出血量、上切缘间距、术后下床活动时间、术后排气时间、术后住院时间均多于经腹组(P<0.05);淋巴结清扫数目、阳性淋巴结个数、切缘阳性数与经腹组相比,差异无统计学意义(P<0.05)。经胸组和经腹组的术后并发症发生率比较,差异无统计学意义(P>0.05)。经胸组和经腹组3年总生存率比较,差异无统计学意义(P>0.05)。结论:对于SiewertⅡ型AEG,经腹入路相比经胸入路具有手术创伤小、术后恢复快的优势,且不影响淋巴结清扫效果及手术远期预后。Objective:To investigate the effect of transthoracic approach and transabdominal approach in the treatment of Siewert typeⅡadenocarcinoma of esophagogastric junction(AEG).Methods:A total of 96 patients with Siewert typeⅡAEG were retrospectively analyzed.According to the different surgical approaches,they were divided into two groups,62 cases in the transthoracic group(treated with AEG radical resection through the left thoracic approach)and 34 cases in the abdominal group(treated with AEG radical resection through the abdominal diaphragmatic esophageal hiatus approach).The lymph node dissection,postoperative recovery and overall survival were compared between the two groups.Results:The operation time,intraoperative blood loss,upper margin spacing,postoperative ambulation time,postoperative exhaust time and postoperative hospital stay in the thoracic group were significantly higher than those in the abdominal group(P<0.05).There was no significant difference in the number of lymph node dissection,the number of positive lymph nodes and the number of positive margin between the thoracic group and the abdominal group(P<0.05).There was no significant difference in the incidence of postoperative complications between transthoracic group and the abdominal group(P>0.05).There was no significant difference in 3-year overall survival rate between transthoracic group and abdominal group(P>0.05).Conclusion:For SiewertⅡAEG,transabdominal approach has the advantages of small surgical trauma and rapid postoperative recovery compared with transthoracic approach,and does not affect the effect of lymph node dissection and long-term prognosis.

关 键 词：SiewertⅡ型食管胃结合部腺癌 经胸入路 经腹入路 淋巴结清扫 预后 

分 类 号：R735.2[医药卫生—肿瘤]