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[目的]探讨贲门癌累及食管下段经腹手术的可行性。[方法]25例贲门腺癌,累及食管下段<3cm,行经腹、经食管裂孔近端半胃切除间置空肠重建消化道术式,与33例贲门癌明确累及食管下段经腹完成有困难行经左胸近端半胃切除食管残胃吻合术式者对比分析。[结果]全组病例病理切缘均阴性;两组术中出血量、肿瘤根治程度比较无明显差异;经腹手术组术后吻合口瘘1例,不全肠梗阻2例,反流性食管炎1例;经左胸手术组肺部感染2例,乳糜胸1例,心血管系统并发症3例,反流性食管炎6例;经腹组心肺并发症及反流性食管炎发生率相对较低。[结论]贲门腺癌累及食管下段<3cm行经腹手术是安全可行的。
[Objective] To investigate the feasibility of gastric cardia cancer involving lower esophageal transabdominal surgery. [Method] Twenty-five cases of cardia adenocarcinoma, involving the lower esophagus <3cm, underwent transabdominal and transhepatic half-gastrectomy of esophageal hiatus to reconstruct the gastrointestinal tract, and 33 cases of cardia cancer have definite involvement in transabdominal transection Comparative analysis of proximal left half gastrectomy esophagogastric anastomosis. [Results] The pathological margins of all the cases were negative. There was no significant difference between the two groups in the amount of hemorrhage and the degree of radical treatment. One case of anastomotic fistula, two cases of incomplete intestinal obstruction, two cases of reflux esophagitis 1 case of pulmonary infection in the left thoracic surgery group 2 cases, 1 case of chylothorax, cardiovascular complications in 3 cases, reflux esophagitis in 6 cases; abdominal and abdominal complications of cardiopulmonary complications and reflux esophagitis incidence rate relative Lower. [Conclusion] Gastric cardia adenocarcinoma involving esophageal lower segment <3cm is safe and feasible for transabdominal surgery.