【摘要】 目的近年来,食管胃交界部腺癌在全球范围内发病率呈上升趋势。手术为该病的主要治疗手段。目前该病的手术方式选择(包括手术入路、切除范围、淋巴结清扫范围等方面)多样,存在争议。现探讨Siewert II型食管胃交界部腺癌外科治疗策略与术式选择。方法回顾性分析2006年1月至2011年1月收治的370例资料完整行外科治疗的SiewertⅡ型食管胃交界部腺癌患者临床资料,分为经胸与经腹两种手术入路。通过分析不同术式患者一般资料、围手术期情况、肿瘤学根治性、并发症以及生存预后,探讨食管胃交界部腺癌外科治疗策略与术式选择。结果全组370例患者,经左胸途径手术治疗266例(经胸组),经腹手术104例(经腹组)。两组手术并发症发作率分别为10.2%(27/266)和10.5%(11/104),差异无统计学意义(P=0.529)。术后1、3、5年生存率两组分为为83.7%、43.9%、33.1%和85.9%、37.8%、29.8%,差异无统计学意义(P=0.761)。结论 SiewertⅡAEG患者选择经胸或经腹的手术方式应个体化。更多还原

【Abstract】 Objective In resent years,the incidence of adenocarcinoma of the esophagogastric junction( AEG) is increasing in the world. Surgery is the main method of treatment. The surgical procedures of AEG are diverse and even controversy. Now explore the surgical treatment strategies and surgical approach of Siewert Ⅱ AEG. Methods Clinic and pathological datas were collected retrospectively in 370 patients with Siewert Ⅱ AEG who underwent surgery in our department between January 2006 and January 2011. All the cases were grouped as transthoracic approach and transabdominal approach. By analyzing the general information,perioperative,oncology radical,complications,and survival prognosis of all the cases, explore the surgical treatment strategies and surgical procedure of Siewert Ⅱ AEG.Results of the 370 patients,266 underwent operation via transthoracic approach all 104 via transabdominal approach.The postoperalive complication rates were 10. 2%( 27/266) and 10. 5%( 11/104) and the 1,3,5 year overall survival rates were 83. 7%,43. 9%,33. 1% and 85. 9%,37. 8%,29. 8% in transthoracic and transabdominal groups respectively,and the difference were not statistically significant( both P > 0. 05). Conclusion Patients with siewert Ⅱ AEG should chose different curgical procedure according to their own circumstances.更多还原