论文部分内容阅读
目的 :探讨贲门癌切除术后上切缘癌阳性的相关因素及预防措施。方法 :回顾分析经上腹正中切口、胸腹联合切口及经左胸后外侧切口贲门癌切除术 842例 ,统计资料用卡方检查。结果 :上切长度≤ 3cm、浸润溃疡型、弥漫浸润型、侵犯浆膜、低分化、有淋巴结转移、经腹手术其上切缘癌阳性率分别为 47.5 % (P<0 .0 1)、19.0 4% (P<0 .0 1)、13.82 % (P<0 .0 1)、13.94% (P<0 .0 5 )、15 .95 % (P<0 .0 1)、13.12 % (P<0 .0 5 )、19.6 5 % (P<0 .0 1)。结论 :贲门癌手术上切长度不足是导致上切缘癌阳性的主要原因。上切缘癌阳性还与病理形态、浸润深度、分化程度、有无淋巴结转移及手术径路有密切关系。可根据相关因素作相应的预防措施 ,减少上切缘癌阳性率。
Objective: To explore the related factors and preventive measures of positive margin cancer after cardiac cancer resection. Methods :A retrospective analysis was performed on 842 cases of cardiac cancer resection through transabdominal midline incision, thoracoabdominal incision, and left posterolateral chest incision. The statistical data were examined by chi-square test. RESULTS: The positive rate of the upper margin was 47.5 % (P < 0.01) for the upper cut length ≤ 3 cm, infiltration ulcer type, diffuse infiltration type, invasion of serosa, poorly differentiated, lymph node metastasis, and abdominal surgery. 19.0 4% (P<0.01), 13.82% (P<0.01), 13.94% (P<0.05), 15.95% (P<0.01), 13.12% ( P<0.05) and 19.65% (P<0.01). Conclusion : The lack of length of the upper cut of cardiac cancer is the main reason leading to the upper margin cancer. The positive margin of the upper margin is also closely related to pathological morphology, depth of invasion, degree of differentiation, lymph node metastasis, and surgical approach. According to relevant factors, corresponding preventive measures can be taken to reduce the positive rate of cancer on the upper margin.