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目的近年来,食管胃交界部腺癌在全球范围内发病率呈上升趋势。手术为该病的主要治疗手段。目前该病的手术方式选择(包括手术入路、切除范围、淋巴结清扫范围等方面)多样,存在争议。现探讨Siewert II型食管胃交界部腺癌外科治疗策略与术式选择。方法回顾性分析2006年1月至2011年1月收治的370例资料完整行外科治疗的SiewertⅡ型食管胃交界部腺癌患者临床资料,分为经胸与经腹两种手术入路。通过分析不同术式患者一般资料、围手术期情况、肿瘤学根治性、并发症以及生存预后,探讨食管胃交界部腺癌外科治疗策略与术式选择。结果全组370例患者,经左胸途径手术治疗266例(经胸组),经腹手术104例(经腹组)。两组手术并发症发作率分别为10.2%(27/266)和10.5%(11/104),差异无统计学意义(P=0.529)。术后1、3、5年生存率两组分为为83.7%、43.9%、33.1%和85.9%、37.8%、29.8%,差异无统计学意义(P=0.761)。结论 SiewertⅡAEG患者选择经胸或经腹的手术方式应个体化。
Objectives In recent years, the incidence of esophageal and gastric adenocarcinoma in the world is on the rise. Surgery is the main treatment of the disease. At present, the surgical options of the disease (including surgical approach, resection range, lymph node dissection, etc.) are diverse and controversial. Surgical treatment of Siewert type II esophagogastric junction adenocarcinoma and surgical options. Methods The clinical data of 370 patients with Siewert Ⅱ type esophagogastric junction adenocarcinoma who underwent complete surgical treatment from January 2006 to January 2011 were retrospectively analyzed and divided into transthoracic and transabdominal surgical approaches. By analyzing the general information of different surgical patients, perioperative conditions, oncology radical, complications and survival prognosis, esophageal and gastric junction adenocarcinoma surgical treatment strategies and surgical options. Results A total of 370 patients were treated with left thoracic surgery in 266 cases (transthoracic group) and transabdominal surgery in 104 cases (transabdominal group). The rates of surgical complications in the two groups were 10.2% (27/266) and 10.5% (11/104) respectively, with no significant difference (P = 0.529). The postoperative 1, 3, 5-year survival rates were 83.7%, 43.9%, 33.1% and 85.9%, 37.8% and 29.8%, respectively, with no significant difference (P = 0.761). Conclusion Siewert Ⅱ AEG patients should be individualized by transthoracic or transabdominal surgery.