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目的 探索治疗贲门部癌的手术入路新方法。方法 经腹切开膈肌脚入路 ,用国产吻合器行纵隔内食管胃吻合 89例、食管空肠吻合 16例。结果 在切除肿瘤及其上方 7cm食管的同时 ,清除纵隔下部淋巴结 ,淋巴结转移率为 2 0 9%。全组病例无手术死亡 ,无吻合口瘘 ,亦无食管切缘癌残留。术后并发症发生率 4 76 % ,5年生存率 39%。结论 经腹切开膈肌脚纵隔内食管胃 (空肠 )机械吻合术 ,操作简便 ,术野暴露良好 ,创伤及生理扰乱较小 ,能有效地预防吻合口瘘 ,且便于切除足够长度食管和扩大淋巴结清除范围。适用于浸润食管长度 <2cm的贲门部癌的外科治疗。
Objective To explore a new surgical approach to the treatment of cardia cancer. Methods Abdominal incision diaphragmatic muscle approach, with domestic stapler line mediastinal esophageal anastomosis in 89 cases, esophageal jejunum anastomosis in 16 cases. Results The resection of the tumor and its upper 7 cm esophagus, while removing the mediastinal lymph nodes, lymph node metastasis rate of 20.9%. All patients without surgical death, no anastomotic leakage, there is no residual cancer of the esophageal margin. The incidence of postoperative complications was 76.6% and the 5-year survival rate was 39%. Conclusions Transabdominal esophageal (jejunal) mechanical anastomosis of the mediastinum in the mediastinum of the diaphragm is simple and easy to operate with good exposure to the surgical field and less trauma and physiological disturbance. It can effectively prevent the anastomotic fistula and facilitate the resection of the esophagus and the enlarged lymph nodes Clear range. Surgical treatment of gastric cardia carcinoma infiltrating esophagus <2 cm in length.