两种经腹手术入路治疗SiewertⅡ型和Ⅲ型食管胃结合部腺癌的效果比较

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Abstract Objective To compare two operation methods for treating Siewert Ⅱ, Ⅲtype adenocarcinoma of esophagogastric (AEG) junction via abdominal approach, namely total gastrectomy and proximal gastrectomy. Methods The clinical data of 51 patients with Siewert Ⅱ,Ⅲ type AEG, from October 2007 to May 2011, in Department of Surgery, Baoji Hospital of Traditional Chinese Medicine, were analyzed retrospectively, among them, 32 cases were given total gastrectomy and 19 cases were given proximal gastrectomy. The differences in patients' age, clinical and pathological characteristics, operation time, intra-operative blood loss, postoperative pathologic staging, nutritional status and postoperative survival situation between the two groups were compared. Results Total gastrectomy group was better on lymph nody excision than the proximal gastrectomy group, while average operation time and average intra-operative blood loss were higher than those of proximal gastrectomy, the differences were statistically significant (P < 0.05); There were no statistically significant differences in occurrence rate of complications during perioperative period between the two groups (P > 0.05). Compared with total gastrectomy group, proximal gastrectomy group was more licked to occured the esophagogastricl reflux after operation 1 year, the differences were statistically significant (P < 0.05). There was statistically significant difference in nutritional status between the two groups after operation 1 year (P > 0.05). The survival rate of the two groups had no statistically significant difference after operation 5 years (P > 0.05), 5-year survival rate of Ⅲ phase patients in total gastrectomy group was 12.50%, that in proximal gastrectomy group was 10.53%. Conclusion The occurrence rate of esophagogastric reflux for total gastrectomy is significantly lower than proximal gastrectomy and the risk of operation will not be increased, there is no significant difference between total gastrectomy and proximal gastrectomy in postoperative nutritional status, it is a suitable operation method for Siewert Ⅱ type and Ⅲ type AEG patients.

Key words： Adenocarcinoma of esophagogastric junction Total gastrectomy Proximal gastrectomy Curative effective

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	ZHANG Rui1 LI Xiao2▲

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ZHANG Rui1 LI Xiao2▲. Comparison of effective of two operation methods for treating Siewert Ⅱ type and Ⅲ type adenocarcinoma of esophagogastric junction via abdominal approach[J]. 中国医药导报, 2017, 14(26): 79-82.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I26/79

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