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目的探讨经腹和经胸两种手术路径治疗贲门癌的疗效差异。方法选取伊川县人民医院收治的贲门癌患者164例,其中经腹手术61例,经胸手术103例。所有患者均行贲门癌根治术和淋巴结清扫,比较两组患者的手术时间、术中输血量、术后住院时间、切缘癌残留率、术后相关并发症和2年生存率等指标。结果两组患者均顺利完成手术,两组患者的手术时间、切缘癌残留率和术后相关并发症比较差异无统计学意义。经胸手术组患者术中均需输血,输血量为400~800 ml,平均600 ml,经腹手术组患者仅11例需要输血,输血量为400 ml,两组比较差异有统计学意义。术后住院时间:经腹组为7~14 d,平均(10±2.2)d,经胸组为9~17 d,平均(13±3.1)d,两组比较差异有统计学意义。结论经腹手术和经胸手术两种入路对贲门癌根治效果和并发症及2年生存率等比较差异无统计学意义,但经腹手术可减少患者术中出血,同时缩短患者的住院时间,与经胸手术相比有一定优势。
Objective To investigate the difference in efficacy of transabdominal and transthoracic surgical approaches for treating cardiac cancer. Methods One hundred and sixty-four patients with cardiac cancer admitted to Yichuan County People’s Hospital were selected, including 61 cases undergoing abdominal surgery and 103 cases undergoing transthoracic surgery. All patients underwent radical gastrectomy and lymph node dissection. The operative time, intraoperative blood transfusion volume, postoperative hospital stay, residual margin at the margin, postoperative complications, and 2-year survival rate were compared between the two groups. Results The operations of the two groups of patients were completed successfully. There was no significant difference in the operation time, residual margin of the margin cancer, and postoperative complications between the two groups. Transthoracic surgery patients required blood transfusion, blood transfusion volume was 400 ~ 800 ml, an average of 600 ml, only 11 patients required transabdominal surgery group required blood transfusion, blood transfusion of 400 ml, the difference between the two groups was statistically significant. Postoperative hospital stay: 7-14 days in the abdominal group, average (10±2.2) days, and 9-17 days in the transthoracic group, with an average of (13±3.1) days. There was a statistically significant difference between the two groups. Conclusions There are no significant differences in radical cure effect, complications and 2-year survival rate between abdominal surgery and transthoracic surgery. However, abdominal surgery can reduce intraoperative bleeding and shorten hospital stay. Compared with transthoracic surgery, there are certain advantages.