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目的探讨贲门癌累及腹段食管的手术方式及其疗效。方法 2008年5月—2009年10月共56例浸润腹段食管贲门癌患者接受手术治疗,胸腹联合术式32例,术中经腹膈肌切开24例,分析其临床资料和病理结果。结果手术均获成功,无手术死亡及严重并发症发生。与胸腹联合切口组相比,经腹膈肌切开组的切口长度短,手术时间短,哌替啶用量少,吸氧时间短,动脉血氧饱和度高,术后胸管引流量少,二组差异有统计学意义(P<0.05);二组清扫淋巴结组数,术后住院时间,肺感染,切缘阳性比较差异无统计学意义(P>0.05);但经腹膈肌切开组心律失常发生率高(P<0.05)。结论贲门癌侵润腹段食管应视具体情况实施不同手术方式。
Objective To investigate the surgical methods and curative effects of gastric cardia carcinoma involving the abdominal esophagus. Methods From May 2008 to October 2009, 56 patients with infiltrating abdominal segment of esophagus and cardia cancer underwent thoracotomy combined with surgery of the thorax and abdomen. Thirty-two patients underwent abdominal thoracotomy and 24 patients underwent abdominal diaphragmatic resection. The clinical data and pathological findings were analyzed. Results The operation was successful, no operative death and serious complications occurred. Compared with thoracoabdominal incision group, transabdominal diaphragmatic incision group incision length short, shorter operative time, less pethidine, oxygen inhalation time, arterial oxygen saturation, less postoperative chest drainage (P <0.05). There was no significant difference between the two groups in the number of lymph node dissection, postoperative hospital stay, lung infection and positive margins (P> 0.05). However, transabdominal diaphragmatic dissection Group arrhythmia incidence was high (P <0.05). Conclusions Cardiac cancer invading the abdominal section of the esophagus should be implemented as the case may be different surgical methods.