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目的探讨食管胃交界部腺癌(AEG)(Siewert分型II/Ⅲ型)切口手术径路不同方法的效果比较。方法选择我院2006年2月至2010年3月收治的AEG患者78例,分别行经腹根治术与经胸根治术,对临床效果进行比较分析。结果经腹组和经胸组的手术时间分别为(182.6±100.2)(147.1±46.0)min(P=0.007),淋巴结平均清扫的数量分别(17.0±9.4)枚和(21.7±10.8)枚(P=0.000),术后发热时间分别为(3.0±1.6)min和(2.4±1.46)min(P=0.000),术后并发症发生率23.0%和12.8%(P=0.005),住院时间为(18.4±13.9)和(16.0±9.0)(P=0.029),两组住院死亡率差异无统计学意义(P=0.702)。结论经腹部切口切除食管胃交界部腺癌(AEG)(Siewert分型II/III)对心肺功能的影响较小,手术时间缩短,患者术后发热时间短,术后引流量减少,手术后并发症的发生率低,住院时间缩短,医疗花费减少,手术安全,手术并发症的发生率少,使手术安全性得到保障。
Objective To investigate the efficacy of different methods of incision approach for esophageal-gastric junction adenocarcinoma (Siewert type II / III) incision. Methods Seventy eight AEG patients admitted from February 2006 to March 2010 in our hospital were treated with transabdominal radical mastectomy and transthoracic radical mastectomy respectively. The clinical effects were compared and analyzed. Results The operation time of the transabdominal and transthoracic groups was (182.6 ± 100.2) (147.1 ± 46.0) min (P = 0.007), the average number of lymph nodes was (17.0 ± 9.4) and (21.7 ± 10.8) P = 0.000). The postoperative fever time was (3.0 ± 1.6) min and (2.4 ± 1.46) min respectively (P = 0.000). The postoperative complication rates were 23.0% and 12.8% (P = 0.005) (18.4 ± 13.9) and (16.0 ± 9.0), respectively (P = 0.029). There was no significant difference in in-hospital mortality between the two groups (P = 0.702). Conclusions The resection of esophagogastric junctional adenocarcinoma (Siewert type II / III) by transabdominal incision has less influence on cardiopulmonary function, shortened operation time, short postoperative fever, reduced postoperative drainage and postoperative complications The incidence of disease is low, hospitalization time is shortened, medical expenses reduced, surgical safety, the incidence of surgical complications less, so that surgical safety is guaranteed.