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目的探讨提高胃底贲门癌手术切除率及远期疗效的最佳方法;探讨手术路径、操作要点及并发症的预防措施。方法对比分析单纯经胸或单纯经腹的近端胃切除与经胸、腹联合切口行全胃切除术对疾病远期效果的影响。结果胸外科经胸近端胃切除36例;普外科单纯经腹近端胃切除10例,全胃切除3例;经胸腹联合切口全胃切除79例。比较:近端胃切除不利于淋巴结清扫,达不到根治效果。经胸腹联合切口的全胃切除既有利于淋巴结清扫,又能切除足够长度的食管,手术切除率高。结论胃底贲门癌经胸腹联合切口全胃切除效果好。
Objective To explore the best way to improve the surgical resection rate and long-term curative effect of gastric cardia carcinoma of the stomach. To explore the surgical approach, operation points and the preventive measures of complications. Methods The comparative analysis of long-term effect of simple gastrectomy or simple transabdominal gastrectomy and transthoracic and abdominal combined total gastrectomy on the long-term effect of the disease. Results Thoracotomy thoracic proximal gastrectomy in 36 cases; general surgery only proximal abdominal gastrectomy in 10 cases, total gastrectomy in 3 cases; thoracoabdominal combined incision total gastrectomy in 79 cases. Comparison: proximal gastrectomy is not conducive to lymph node dissection, not up to radical effect. The total gastrectomy by thoracoabdominal incision not only conducive to lymph node dissection, but also cut enough length of the esophagus, surgical resection rate. Conclusion Gastric cardia cancer through thoracoabdominal incision total gastrectomy effect.