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目的探讨贲门癌探查手术不能切除的原因。方法回顾性分析72例贲门癌手术探查患者术前临床表现、影像学检查、内镜检查、病理类型及术中情况。结果患者术前虽经过充分评估手术切除的可能性,但72例贲门肿瘤均侵及周围脏器,至少1个周围脏器受侵,其中侵及2个以上脏器者50例;探查原因为肿块较大,侵及胰腺、脾、胃左动脉、腹腔动脉等使瘤体无法和周围组织及脏器分离,部分患者有革袋胃表现。结论提高贲门癌切除率、减少手术探查的关键是早期发现、早期诊断、早期治疗。术前综合评估贲门肿瘤手术切除的可能性只能减少探查术,但不能杜绝。
Objective To investigate the causes of unresectable cardia cancer exploration. Methods The clinical manifestations, imaging examination, endoscopy, pathological types and intraoperative findings of 72 patients with cardia cancer surgical exploration were retrospectively analyzed. Results Although the patients had undergone sufficient resection of the surgical resection before surgery, 72 cases of cardia tumors invading the surrounding organs, at least one surrounding organs invaded, of which 50 cases of more than two organs invaded; probe for Larger tumor, invading the pancreas, spleen, left gastric artery, celiac artery so that the tumor can not be separated from the surrounding tissues and organs, some patients have leather bag performance. Conclusion The key to improve the resection rate of cardia cancer and reduce surgical exploration is early detection, early diagnosis and early treatment. Comprehensive assessment of the possibility of surgical resection of cardiac cancer can only reduce the exploration technique, but can not be eliminated.