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目的探讨贲门癌手术入路的最佳方法。方法回顾性分析2009年6月至2014年6月间诊治的168例贲门癌手术患者经上腹正中入路或经左胸后外侧入路手术的临床资料,按不同手术入路分为经腹组(102例)和经胸组(66例),比较两组患者的手术效果、有效性指标、并发症发生率及生活质量评分情况。结果两组患者死亡病例、平均清扫淋巴结枚数、上切缘癌阳性残留例数的差异均无统计学意义(均P>0.05)。经腹组患者的手术时间、住院时间短于经胸组,术中出血量少于对经胸组,经腹组患者术后并发症发生率为11.8%(12/102),少于经胸组的30.3%(20/66),差异均有统计学意义(均P<0.05);经腹组患者生活质量优于经胸组,差异有统计学意义(P<0.05)。结论经腹手术对贲门癌患者的效果更佳,值得临床推广。
Objective To explore the best method of surgical approach of cardia cancer. Methods A retrospective analysis of 168 cases of cardia cancer patients diagnosed and treated between June 2009 and June 2014 were retrospectively analyzed. The clinical data of the patients who underwent transabdominal median approach or left thoracic posterolateral approach were divided into transabdominal (102 cases) and transthoracic group (66 cases). The operative effect, the validity index, the complication rate and the quality of life score of the two groups were compared. Results There was no significant difference between the two groups in the number of deaths, the average number of lymph nodes and the number of positive residual cases on the margin of the margin (all P> 0.05). The operation time and hospital stay of transabdominal group were shorter than that of transnasal group, the intraoperative blood loss was less than that of transabdominal group and transabdominal group. The incidence of postoperative complications was 11.8% (12/102) (P <0.05). The quality of life of the transabdominal group was better than that of the thoracic group, the difference was statistically significant (P <0.05). Conclusion The effect of transabdominal surgery on patients with cardia cancer is better and is worthy of clinical promotion.