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目的 :总结贲门癌的手术方法 ,探讨最佳手术径路。方法 :对 840例行手术探查的贲门癌患者 ,比较经左胸、胸腹联合和经腹三种手术入路的差异 ,用 χ2 检验、秩和检验和F检验。结果 :三种手术方式的切除率分别为 72 .7%、82 .1%和 46 .7%(P <0 .0 0 5 ) ;上切缘阳性率分别为 5 .6 %、4.3%和 14.3% (P <0 .0 5 ) ;下切缘阳性率分别为 7.2 %、3.9%和 5 .4% (P >0 .0 5 ) ;清除淋巴结数以胸腹联合切口最多 (P <0 .0 5 )。患者肺部感染、吻合口瘘等并发症的发生率相似 (P >0 .0 5 ) ;手术切除时间相似 (P >0 .0 5 ) ;而术后住院天数差异有显著性 (P <0 .0 5 )。结论 :贲门癌的手术径路应根据患者的具体情况选择 ,胸腹联合切口的切除率较高 ,且并发症少。
Objective: To summarize the surgical methods of cardia cancer and explore the best surgical approach. Methods: 840 patients underwent surgical exploration of cardia cancer patients, the left thoracic, thoracoabdominal and abdominal transabdominal surgery were compared by three methods, χ2 test, rank sum test and F test. Results: The resection rates of the three surgical approaches were 72.7%, 82.1% and 46.7%, respectively (P <0.05). The positive rates of the upper margin were 5.6%, 4.3% and The positive rate of the lower margin was 7.2%, 3.9% and 5.4% respectively (P> 0.05). The number of clear lymph nodes was the largest in the thoracoabdominal and abdominal incision (P <0. 05). 0 5). The incidence of pulmonary infection and anastomotic fistula was similar in all patients (P> 0.05). The time of surgical resection was similar (P> 0.05), while the number of postoperative hospital days was significantly different (P <0. 05) .0 5). Conclusion: The operation path of cardia cancer should be selected according to the specific conditions of the patients. The resection rate of thoracoabdominal incision is high, and the complications are few.