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自1984年3月至1996年12月行贲门癌切除术共70例,均经胸切口手术。本组资料表明:癌肿侵及浆膜者58例,占83%;组织学分类中低分化腺癌20例.占29%,上切端距瘤体上缘5cm,切端阳性2例,占2.9%;贲门周围淋巴结转移者占81%;食管下段淋巴结转移者占26%。提示责门癌可侵犯食管下段5cm以上,且食管下段周围淋巴结转移率较高。为彻底清除癌转移淋巴结及切除足够的食管长度,作者主张剖胸入路,并强调术中除彻底清扫1、2、3、4、7组淋巴结外,亦应把食管下段淋巴结(110组)作为重点进行清扫。另外,剖胸贲门癌根治者,特别是老年患者,作好围手术期处理对防止术后并发症十分必要。
From March 1984 to December 1996, a total of 70 cases of cardia cancer resection were performed with chest incisions. The data in this group showed that: 58 cases of cancer invasion and serosa, accounting for 83%; histological classification of poorly differentiated adenocarcinoma in 20 cases. accounted for 29%, the upper end of the cut from the tumor edge of 5cm, cut end in 2 cases, accounting for 2.9 %; 81% of lymph nodes metastasis around the cardia; 26% of the lower esophageal lymph node metastasis. It is suggested that the cancer of the target can violate the lower esophageal segment more than 5cm, and the lymph node metastasis rate around the lower esophagus is high. In order to completely remove cancer metastasis and to remove enough esophageal length, the author advocates a thoracotomy approach and emphasizes that in addition to thorough cleaning of 1, 2, 3, 4 and 7 groups of lymph nodes, the lower esophageal lymph nodes should also be included (group 110). Focus on cleaning. In addition, radical excision of breast cancer, especially in elderly patients, it is necessary to do perioperative management to prevent postoperative complications.