【摘要】 目的 :总结贲门癌的手术方法 ,探讨最佳手术径路。方法 :对 840例行手术探查的贲门癌患者 ,比较经左胸、胸腹联合和经腹三种手术入路的差异 ,用 χ2 检验、秩和检验和F检验。结果 :三种手术方式的切除率分别为 72 .7%、82 .1%和 46 .7%(P <0 .0 0 5 ) ;上切缘阳性率分别为 5 .6 %、4.3%和 14.3% (P <0 .0 5 ) ;下切缘阳性率分别为 7.2 %、3.9%和 5 .4% (P >0 .0 5 ) ;清除淋巴结数以胸腹联合切口最多 (P <0 .0 5 )。患者肺部感染、吻合口瘘等并发症的发生率相似 (P >0 .0 5 ) ;手术切除时间相似 (P >0 .0 5 ) ;而术后住院天数差异有显著性 (P <0 .0 5 )。结论 :贲门癌的手术径路应根据患者的具体情况选择 ,胸腹联合切口的切除率较高 ,且并发症少。更多还原

【Abstract】 ?Objective:To evaluate the methods of surgical approaches in treatment of carcinoma of the gastric cardia.Methods:Eight hundred forty patients with carcinoma of the gastric cardia were operated with 3 different approaches:the left thoracicic incision,thoracico abdominal incision and upper abdominal incision.The results among the 3 groups were assessed by χ 2 test,rank sum test and F test.Results:The resection rates of the 3 groups were 72.7%, 82.1 % and 46.7% respectively( P <0.005).The positive rate of upper incisal margin was 5.6%,4.3% and 14.3% respectively( P <0.05).The positive rate of lower incisal margin was 7.2%,3.9% and 5.4% respectively( P >0.05).More lymph nodes were cleared off through thoracico abdominal incision ( P <0.05) .The complications,such as pulmonary infection and anastomotic leakage were similar in 3 groups ( P >0.05 ).Conclusions:The method of operative approaches of carcinoma of gastria cardia should be selected according to the conditions of the patients.The resection rate is the highest in thoracico abdominal incision.更多还原