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目的：探讨近侧胃大部分切除术和全胃切除术治疗贲门癌的综合疗效和手术切口的选择。方法：自１９８５年１月至１９９３年４月共手术治疗贲门癌１９４例，其中近侧胃大部切除术１０６例（Ａ组）、全胃切除术８８例（Ｂ组）。对Ａ、Ｂ两组的淋巴结阳性情况，３、５年生存情况及主要并发症的发生率进行比较。结果：Ｂ组幽门上下组淋巴结转移率高达１４．７％；Ｂ组的Ⅱ、Ⅲ期病人的３年、５年生存率明显高于Ａ组（Ｐ＜０．０５），而返流性食管炎的发生率明显低于Ａ组（Ｐ＜０．０１）。结论：对可切除的贲门癌应多采用全胃切除术。手术切口应多采用左侧胸腹联合切口，以提高手术的安全性和彻底性。
Objective: To investigate the general curative effect of radical gastrectomy and total gastrectomy for cardiac cancer and the choice of surgical incision. Methods: From January 1985 to April 1993, a total of 194 cases of cardiac cancer were treated surgically, including 106 cases of proximal gastrectomy (group A) and 88 cases of total gastrectomy (group B). The positive status of lymph nodes in groups A and B, and the survival rate of 3 and 5 years and the incidence of major complications were compared. Results: The lymph node metastasis rate in group B was as high as 14.7% in group B; the 3-year and 5-year survival rates in group B and II were significantly higher than those in group A (P<0.05), but reflux esophageal The incidence of inflammation was significantly lower than in group A (P<0.01). Conclusion: Total gastrectomy should be used for resectable cardiac cancer. Surgical incision should be used on the left thoracoabdominal combined incision to improve the safety and thoroughness of the operation.