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目的探讨进展期贲门癌的外科手术治疗。方法对60例进展期贲门癌患者施行全胃切除及D2以上的淋巴结清扫,分析贲门癌浸润胃壁深度与淋巴结转移、淋巴转移与术后累积生存率的关系。结果本组贲门癌患者术后3年、5年累积生存率分别为46.2%和35.1%;总的淋巴结转移例数为45例,转移率为75%,随着肿瘤浸润深度的增加,淋巴结转移率增加;本组贲门癌患者术后并发症发生率与病死率分别为13.3%和1.67%。结论对进展期贲门癌患者只要条件许可应施行根治性全胃切除(D2+术式)并进行淋巴清扫,必要时联合脾、胰体尾整块切除,以提高生存质量和延长生存期。
Objective To investigate the surgical treatment of advanced cardia cancer. Methods Total gastrectomy and dissection of lymph nodes over D2 were performed in 60 patients with advanced cardia cancer. The relationship between the gastric wall depth and lymph node metastasis, lymph node metastasis and postoperative cumulative survival rate was analyzed. Results The 3-year, 5-year cumulative survival rates of patients with cardia cancer were 46.2% and 35.1% respectively. The total number of lymph node metastases was 45 and the metastasis rate was 75%. As the depth of tumor invasion increased, lymph node metastasis Rate increased; the incidence of postoperative complications and mortality in patients with cardia cancer were 13.3% and 1.67%. Conclusions Radical total gastrectomy (D2 +) and lymphadenectomy should be carried out in patients with advanced cardia cancer as long as conditions permit. Combined with splenic and pancreatic body tail resections if necessary, to improve quality of life and prolong survival.