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目的对28例贲门癌患者临床病理特点及围手术期治疗进行分析。方法术前有伴发疾病的21例占75%,所有患者均进行手术治疗,其中胸腹联合切口径路24例,经腹正中切口径路4例,全胃切除6例,胃近端大部切除18例,19例均不同程度行术前或术后化疗。结果术后并发症发生率46.2%,随访19例,占67.8%,一年生存率为63.2%,二年生存率为52.6%,4例死于癌肿复发,2例分别死于脑血管意外及心力衰竭。结论贲门癌作为胃癌中的特殊性,尤其是有伴发疾病者其围手术期治疗手术径路、切除范围、清扫范围、综合化疗等不完全一致。要提高五年生存率术前应积极治疗伴发疾病,加强术前有关功能锻炼,结合影像学改变制定合理的手术方法,合理应用抗生素,术后综合治疗,提高患者的生存期及生存质量。
Objective To analyze the clinicopathological characteristics and perioperative treatment of 28 patients with cardiac cancer. Methods Twenty-one patients (75%) had concomitant diseases preoperatively. All the patients underwent surgical treatment. Among them, 24 were thoracoabdominal incision approach, 4 were trans-abdominal median incision approach, 6 were total gastrectomy, 18 cases were removed, and 19 cases were treated with preoperative or postoperative chemotherapy to varying degrees. Results The incidence of postoperative complications was 46.2%, 19 cases were followed up (67.8%), the one-year survival rate was 63.2%, the two-year survival rate was 52.6%, 4 died of cancer recurrence and 2 died of cerebrovascular accident And heart failure. Conclusions Cardia cancer is not the same as gastric cancer, especially in the patients with concomitant disease, the perioperative treatment of the surgical approach, the scope of resection, the scope of cleaning, such as chemotherapy is not exactly the same. To improve the five-year survival rate should be actively treated with preoperative disease, strengthen preoperative functional exercise, combined with imaging changes to develop a reasonable surgical methods, the rational use of antibiotics, postoperative comprehensive treatment to improve patient survival and quality of life.