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目的探讨外科治疗老年贲门癌的术式及安全性。方法回顾性分析56例老年贲门癌患者的手术治疗,均经腹途径,其中探查3例,根治性全胃切除加淋巴结清扫53例,以空肠代胃袢式吻合18例,空肠P形代胃Roux-en-Y吻合35例。20例借助吻合器,13例行膈肌食管裂孔切开并使用肋缘悬吊拉钩。结果术后合并肺部感染5例,无呼吸衰竭、心力衰竭、无吻合口瘘发生,无围手术期死亡;远期吻合口狭窄2例,粘连性肠梗阻3例发生。一年存活率75.5%(40/53),3年存活率22.6%(12/53)。结论老年贲门癌应以经腹全胃切除加淋巴结清扫术为宜。
Objective To investigate surgical procedures and safety of surgical treatment of cardia cancer in the elderly. Methods Retrospective analysis of 56 cases of elderly patients with cardia cancer surgery, all via abdominal pathology, including 3 cases of exploration, radical gastrectomy plus lymph node dissection 53 cases of jejunal anaphylactoid anastomosis in 18 cases, jejunal P-shaped stomach Roux-en-Y anastomosis in 35 cases. 20 cases with stapling, 13 cases of diaphragm resection of the hiatus and the use of costal hanging hooks. Results There were 5 cases of postoperative pulmonary infection, no respiratory failure, heart failure, no anastomotic leakage, no perioperative death; long-term anastomotic stenosis in 2 cases, adhesive intestinal obstruction occurred in 3 cases. The one-year survival rate was 75.5% (40/53), and the three-year survival rate was 22.6% (12/53). Conclusion Elderly cardia cancer should be transabdominal total gastrectomy plus lymph node dissection is appropriate.