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目的探讨胸腹联合切口在贲门癌手术中的优势。方法回顾性分析1996年6月至2007年12月采用胸腹联合切口治疗贲门癌298例的临床资料。结果根治性切除289例,根治性切除率96.9%(289/298),姑息性切除5例,总切除率为98.3%(293/298),单纯探查5例。并发症发生率为4.5%(13/298),其中吻合口瘘2例,吻合口狭窄1例,呼吸衰竭2例(死亡1例),肺部感染5例,脓胸2例,乳糜胸1例。结论经胸腹联合切口治疗贲门癌有利于肿瘤切除及周围淋巴结清扫,能够提高手术切除率,并发症少,避免肿瘤过度挤压,减少医源扩散,适用病例广,在一定程度上优于左侧单纯开胸或剖腹手术。
Objective To explore the advantages of thoracoabdominal incision in cardia cancer surgery. Methods The clinical data of 298 cases of cardia cancer treated with thoracoabdominal incision between June 1996 and December 2007 were analyzed retrospectively. Results The radical resection of 289 cases, radical resection rate 96.9% (289/298), palliative resection in 5 cases, total resection rate was 98.3% (293/298), simple exploration in 5 cases. The incidence of complications was 4.5% (13/298), including 2 anastomotic leakage, 1 anastomotic stenosis, 2 respiratory failure (1 death), 5 pulmonary infections, 2 empyema, 1 chylothorax example. Conclusion The treatment of cardia cancer by thoracoabdominal incision is helpful for tumor resection and peripheral lymph node dissection, which can improve the resection rate, reduce the complication, avoid over-squeezing tumor and reduce the spread of iatrogenic source, which is better than the left Simple thoracotomy or laparotomy.