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目的:探讨经腹根治性全胃切除术治疗老年贲门癌患者临床疗效。方法:回顾性分析接受根治性全胃切除术治疗的48例老年贲门癌患者的临床资料,根据手术入路的不同将48例患者分经腹组和经胸组,比较两组患者手术时间、术中出血量、术后并发症及生存率。结果:经腹组患者平均手术时间、术中出血量及术后住院时间均明显优于经胸组[(184.4±12.5)min vs.(196.3±16.8)min,(304.5±35.4)mL vs.(354.8±44.7)mL,(11.4±3.7)d vs.(14.5±4.1)d],术后肺部并发症发生率明显低于经胸组(4.5%vs.26.9%),差异均有统计学意义(P<0.05);经腹组与经胸组患者术后1年生存率分别为86.36%,84.62%,两组3年生存率分别为45.46%,42.31%,两组间差异均无统计学意义(P>0.05)。结论:经腹根治性全胃切除术治疗老年贲门癌具有手术创伤小、术后恢复快、术后肺部并发症低的优点。
Objective: To investigate the clinical effect of radical gastrectomy in the treatment of cardia cancer in the elderly. Methods: The clinical data of 48 elderly patients with cardia cancer undergoing radical total gastrectomy were retrospectively analyzed. Forty-eight patients were divided into abdominal and transthoracic groups according to the surgical approach. The operation time, Intraoperative blood loss, postoperative complications and survival rate. Results: The mean operative time, intraoperative blood loss and postoperative hospital stay were significantly better in the transabdominal group than those in the transthoracic group [(184.4 ± 12.5) min vs. (196.3 ± 16.8) min vs (304.5 ± 35.4) mL vs. (354.8 ± 44.7) mL and (11.4 ± 3.7) d vs. (14.5 ± 4.1) d] respectively. The incidence of postoperative pulmonary complications was significantly lower than that of the transthoracic group (4.5% vs.26.9%) (P <0.05). The 1-year survival rates of the transabdominal and transthoracic groups were 86.36% and 84.62%, respectively. The 3-year survival rates of the two groups were 45.46% and 42.31% respectively, with no significant difference between the two groups Statistical significance (P> 0.05). Conclusion: The radical gastrectomy for the treatment of cardia cancer in the elderly has the advantages of less trauma, quick recovery and lower postoperative pulmonary complications.