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目的探讨食管胃结合部肿瘤外科治疗的最佳手术径路。方法对我院2007年1月—2010年9月48例经腹膈肌开窗治疗食管胃结合部肿瘤进行总结分析。结果本组48例中,切缘无癌残留,切除淋巴结372枚,转移率为52.18%(194/372),其中腹腔淋巴结转移率为64.26%(31/48),胸腔淋巴结转移率为26.48%(13/48),未发生吻合口瘘、狭窄、肺部并发症,切口感染2例,腹腔淋巴瘘3例,左侧胸腔积液1例,无围手术期死亡。结论经腹膈肌开窗治疗食管胃结合部肿瘤是一种较理想的手术径路。
Objective To investigate the optimal surgical approaches for the surgical treatment of esophagogastric junction tumors. Methods 48 cases of transvaginal diaphragm windows were treated in our hospital from January 2007 to September 2010 to summarize and analyze the esophagogastric junction tumors. Results In the group of 48 cases, there were no residual cancer at the margin and 372 resected lymph nodes, the metastasis rate was 52.18% (194/372). The rate of lymph node metastasis in abdominal cavity was 64.26% (31/48) and the rate of lymphatic metastasis in the pleural cavity was 26.48% (13/48), no anastomotic fistula, stenosis, pulmonary complications, incision infection in 2 cases, celiac lymphatic fistula in 3 cases, left pleural effusion in 1 case, no perioperative death. Conclusion Transabdominal diaphragmatic window treatment of esophagogastric junction tumor is a more ideal surgical approach.