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目的:探讨如何提高胃底贲门癌尤其是累及食管下段1～2 cm以内的贲门及胃上部癌经腹手术切除成功率,减轻手术创伤,辅以综合治疗,以提高疗效。方法:对61例贲门及胃上部癌中的29例采用术前高选择动脉插管化疗(HSAPC)及术中低渗温盐水灌洗加腹腔化疗等综合治疗。结果:治疗组29例中经腹手术28例(姑息仅3例),经胸手术1例(食道下段受累>2 cm),1、3、5、10年生存率分别为93.1%、62.1%、48.2%、20.7%;而对照组32例中经腹手术19例(姑息达7例),经胸手术达13例。1、3、5、10年生存率分别为81.2%、40.6%、25%、9.4%。结论:胃上部及贲门癌部分累及食管下段,经术前HSAPC可以明显提高经腹手术切除成功率及术后生存期,综合治疗可减少复发。
OBJECTIVE: To explore how to improve gastric cardia cancer, especially in the lower esophageal sacral area and the upper part of the esophagus, and to reduce the success rate of abdominal surgery, reduce the surgical trauma, and supplement the comprehensive treatment to improve the therapeutic effect. METHODS: A total of 61 cases of gastric cardia and upper stomach cancer were treated with preoperative high selective arterial catheterization chemotherapy (HSAPC) and intraoperative hypotonic saline irrigation plus intraperitoneal chemotherapy. Results: In the treatment group, there were 29 cases of abdominal surgery (only 3 cases were palliative), and 1 case of thoracic surgery (the lower esophagus involved >2 cm). The 1-, 3-, 5-, and 10-year survival rates were 93.1% and 62.1%, respectively. , 48.2%, 20.7%; and the control group of 32 cases of abdominal surgery in 19 cases (palpable up to 7 cases), 13 cases of thoracic surgery. The 1, 3, 5, and 10 year survival rates were 81.2%, 40.6%, 25%, and 9.4%, respectively. Conclusion: In the upper part of the stomach and cardiac cancers involving the lower esophagus, preoperative HSAPC can significantly increase the success rate of resection of the abdomen and postoperative survival. Comprehensive treatment can reduce recurrence.