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目的 研究贲门癌选择各种手术径路的临床价值。方法 对本组贲门癌患者 ,术前进行充分的讨论 ,依据病灶范围、全身情况 ,选择合适的手术径路施术 ,对手术彻底性、切除率、切缘阳性率、术后总并发症、吻合口瘘、心肺功能影响等进行分析。结果 本组手术彻底性高 ,手术切除率为95 % ,全胃切除率 12 % ,淋巴结转移率 84 6 % ,总并发症8 7% ,吻合口瘘 0 4% ,心血管并发症 3 % ,呼吸系统并发症 4 4% ,住院死亡率 0 4% ,切缘阳性率 0 6 9% ,其它并发症 0 8%。结论 贲门癌手术应根据病变范围及患者的身体情况 ,选择合适的手术径路 ,可提高手术切除率及彻底性 ,降低死亡率及并发症 ,优于选择单一径路的施术方式
Objective To study the clinical value of various surgical approaches for cardia cancer. Methods The patients with cardia cancer before operation were fully discussed. According to the extent of the lesion and the general condition, the appropriate surgical approach was chosen to evaluate the completeness, resection rate, positive margins, total postoperative complications, anastomosis Fistula, cardiopulmonary function analysis. Results The complete operation of this group was highly successful. Surgical resection rate was 95%, total gastrectomy rate was 12%, lymph node metastasis rate was 84.6%, total complication rate was 8.7%, anastomotic fistula was 0.4%, cardiovascular complication rate was 3% Respiratory complications 4 4%, hospital mortality 0 4%, positive margins 0 69%, other complications 0 8%. Conclusion Cardiac cancer surgery should be based on the extent of the lesion and the patient’s physical condition, choose the appropriate surgical approach, can improve the surgical resection rate and thoroughness, reduce mortality and complications, surpass the choice of a single approach