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贲门癌系发生在胃贲门部的腺癌,对放射及化学治疗反应均差,以外科手术为主要治疗手段.其手术方式主要有:(1)近侧胃次全切除术;(2)扩大的近侧胃次全切除术(包括胰尾部和脾脏);(3)全胃切除术;(4)扩大的全胃切除术(包括胰尾部和脾脏)等.手术方式的选择主要根据肿瘤的病理分期而定.近年来,多数作者主张在贲门癌手术中扩大切除范围,以期达到根治的效果.这一概念的建立,基于对贲门癌淋巴结转移途径、范围的病理解剖学研究.贲门癌一般就治较晚,根据手术标本统计,手术时有胃左淋巴结转移者占56%.贲门上淋巴结转移者80%,贲门下淋巴结转移者12%,胃网膜右淋巴结转移者40%,胰脾淋巴结转移者64%.因此,为
Cardiac cancer occurs in the adenocarcinoma of the gastric cardia and has poor response to radiation and chemotherapy. Surgical procedures are the main treatment. The surgical methods are: (1) subtotal gastrectomy; (2) enlargement Subtotal subtotal gastrectomy (including pancreatic tail and spleen); (3) Total gastrectomy; (4) Extended total gastrectomy (including pancreatic tail and spleen) etc. The choice of surgical approach is mainly based on the The pathological stage may be. In recent years, most authors advocate expanding the scope of resection in cardiac cancer surgery in order to achieve the effect of radical cure. The establishment of this concept is based on the pathological anatomy of the lymph node metastasis pathway and scope of cardia cancer. Treatment later, according to surgical specimens statistics, surgery with left gastric lymph node metastasis accounted for 56%. 8% of patients with supraglottic lymph node metastasis, 12% of patients with metastatic lymph node metastasis, 40% of right gastric lymph node metastasis, pancreatic spleen 64% of lymph node metastases. Therefore, for