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目的:探讨术前较准确评估晚期贲门癌手术切除的可能性,以降低晚期贲门癌手术探查风险。方法:回顾性分析72例晚期贲门癌手术探查患者术前的临床表现、影像学检查、病理类型及术中情况。结果:术中见72 例患者贲门肿瘤均有周围脏器浸润,其中侵及2个以上脏器者16例(22.22%)。钡餐检查32例肿瘤浸润胃小弯, 术中探查41例侵及胃小弯,诊断符合率为78.05%;64例B超检查提示贲门部肿瘤,与术中探查符合率为88.89%;CT扫描贲门癌外侵诊断符合率为88.89%;胸、腹腔淋巴结肿大诊断符合率为100%。结论:病程、肿瘤的大小、疼痛症状、X线钡餐表现及病理类型对贲门癌患者术前肿瘤可切除性的评估起决定性作用。
Objective: To investigate the more accurate preoperative evaluation of the possibility of surgical resection of advanced cardia cancer to reduce the risk of surgical exploration of advanced cardia cancer. Methods: The clinical manifestations, imaging examination, pathological types and intraoperative conditions of 72 patients with advanced gastric cardia carcinoma were analyzed retrospectively. Results: During the operation, 72 patients had cardiac organ infiltration, of which 16 cases (22.22%) had invaded 2 or more organs. Barium meal examination of 32 cases of tumor infiltration of gastric curvature, intraoperative exploration of 41 cases of invading gastric curvature, the diagnostic coincidence rate was 78.05%; 64 cases of B-check prompt cardia tumor, and intraoperative exploration rate was 88.89%; CT scan The coincidence rate of cardia cancer diagnosis was 88.89%, and the coincidence rate of diagnosing thoracic and abdominal lymph nodes was 100%. Conclusion: The course of disease, the size of the tumor, the pain symptom, the X-ray barium meal manifestation and the pathological type play a decisive role in assessing the resectability of the preoperative tumor in patients with cardiac cancer.