摘要
目的比较经腹食管裂孔入路与经胸入路手术治疗SiewertⅡ、Ⅲ型食管胃结合部腺癌(AEG)的临床效果。方法 82例SiewertⅡ、Ⅲ型AEG患者,根据不同手术路径分为经胸手术组(经胸组)38例和经腹食管裂孔手术组(经腹组)44例。比较两组患者术中出血量、手术时间、淋巴结清扫数、术后切口疼痛程度(视觉模拟评分)、术后住院时间、术后并发症发生率等临床资料。结果两组均无围术期死亡病例,根治度均达到R0切除。经腹组手术时间、术中出血量、视觉模拟评分、术后住院时间均明显少于或低于经胸组(P<0.05),腹腔淋巴结清扫数明显多于经胸组(P<0.05)。经腹组术后并发症发生率为11.4%(5/44),明显低于经胸组的31.6%(12/38)(P<0.05)。两组纵隔淋巴结清扫数比较,差异无统计学意义(P>0.05)。结论与经胸入路手术比较,经腹食管裂孔入路治疗SiewertⅡ、Ⅲ型AEG患者在腹腔淋巴结清扫数方面具有明显优势,且术后并发症发生率更低。
Objective To compare the clinical efficacy between transabdominal surgery through esophageal hiatus and transthoracic surgery for the treatment of Siewert type Ⅱor Ⅲadenocarcinoma of the esophao-gastric junction （AEG）. Methods Eighty-two patients with Siewert type Ⅰ or Ⅲ AEG were divided into transthoracic surgery group （transthoracic group, n = 38 ） and transabdominal surgery through esophageal hiatus group （ transabdominal group, n = 44 ） according to the surgical approach. The clinical data were compared between two groups,including intraoperative blood loss, operative time, the number of removed lymph nodes, the scverity of postoperative incision pain（ Visual Analogue Scale score）, postoperative hospital stay and incidence of postoperative complications, ect. Results No perioperative death occurred in both groups, and the radical excision of both groups reached R0. The operation time, iutraoperative blood loss, Visual Analogue Scale score and postoperative hospital stay of transabdominal group were significantly less than those of transthoracic group（P 〈 0.05 ）. And transabdominal group had more number of removed lymph nodes in the abdominal cavity compared to transthoracic group（ P 〈 0.05 ）. The incidence of postoperative complications of transabdominal group was 11.4% （5/44） ,which was significantly lower than that of transthoracic group[ 31.6% （ 12/38 ） ] （ P 〈 0.05 ）. There was no significant difference in the number of removed lymph nodes in the mediastinum between two groups （P 〉 0.05 ）. Conclusion Compared to transthoracic surgery, transabdominal surgery through esophageal hiatus for the treatment of Siewert type Ⅱ or Ⅲ AEG has the advantages in the number of removed lymph nodes in the abdominal cavity, and obtains lower incidence of postoperative complications.
出处
《广西医学》
CAS
2016年第2期204-206,共3页
Guangxi Medical Journal
基金
江苏省南通市市级医学科研计划项目(NTS2014067)
关键词
食管胃结合部腺癌
SiewertⅡ型
SiewertⅢ型
手术入路
经腹
食管裂孔
经胸
疗效
Adenocarcinorna of the esophao-gastric junction, Siewert type Ⅱ, Siewert type Ⅲ, Surgical approach, Transabdominal, Esophageal hiatus, Transthoracic, Efficacy
