论文部分内容阅读
目的总结首发大出血和穿孔急腹症贲门癌的外科治疗经验。方法回顾1990—2004年39例首发急症贲门癌临床治疗情况,其中首发大出血28例,首发穿孔11例;男32例,女7例,年龄48~73岁;确诊后均急诊手术治疗,单纯开腹修补穿孔2例,其余37例均采用左后外开胸贲门癌切除。病理:早期腺癌2例,中分化腺癌12例,低分化腺癌16例,黏液腺癌4例,印戒细胞癌3例;TNM分期:Ⅰ期2例,Ⅱ期9例,Ⅲ期22例,Ⅳ期4例。结果39例无手术死亡,术后1、3、5、10年生存率分别为67.7%(21/31)、48.0%(12/25)、28.6%(6/21)、11.1%(1/9)。结论首发大出血或穿孔急症的贲门癌并不代表肿瘤属于很晚期不能切除,若无明显手术禁忌证,宜尽早手术治疗,综合治疗可提高远期生存率。
Objective To summarize the experience of surgical treatment of first-episode hemorrhage and perforation of acute cardiac cardia cancer. Methods The clinical data of 39 patients with acute cardia cancer who were admitted to our hospital from 1990 to 2004 were retrospectively reviewed. Among them, 28 were initial hemorrhage and 11 were perforation. There were 32 males and 7 females, aged 48-73 years old. All patients underwent emergency surgical treatment Abdominal repair perforation in 2 cases, the remaining 37 cases were treated with left external cardiothoracic resection. Pathology: early adenocarcinoma in 2 cases, moderately differentiated adenocarcinoma in 12 cases, poorly differentiated adenocarcinoma in 16 cases, mucinous adenocarcinoma in 4 cases, signet ring cell carcinoma in 3 cases; TNM stage: stage Ⅰ in 2 cases, stage Ⅱ in 9 cases, stage Ⅲ 22 cases, 4 cases of stage Ⅳ. Results The survival rate of 39 patients was 67.7% (21/31), 48.0% (12/25), 28.6% (6/21) and 11.1% (1 / 9). Conclusion The first cardia cancer with major bleeding or perforation does not mean that the tumor is unresectable. If there is no obvious contraindication, surgical treatment should be done as soon as possible, and comprehensive treatment can improve the long-term survival rate.