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目的从贲门癌手术后的远期生存率方面,比较经腹与经胸两种手术入路的疗效。方法对244例经手术治疗并有随访资料的病例进行统计分析,比较经腹与经胸两种手术入路患者1、3、5年生存率及切缘阳性率的差异。结果两组间患者1、3、5年生存率差异无统计学意义,上切缘阳性率差异具有统计学意义。组内切缘阳性与切缘阴性病例生存率差异具有统计学意义。结论两种手术入路对患者生存率的影响差异无统计学意义,但手术入路选择应个体化,对食管明显受侵患者,应采取经胸入路手术,以降低上切缘阳性率。
Objective To compare the long-term survival rates after cardia cancer surgery, and to compare the efficacy of transabdominal and transthoracic two kinds of surgical approaches. Methods A total of 244 cases of surgical follow-up were retrospectively analyzed. The difference of survival rate at 1, 3, 5 years and the positive rate of the margins between the two methods of transabdominal and transthoracic surgery were compared. Results There was no significant difference in the 1, 3, 5-year survival rates between the two groups. The positive rate of the upper margin was statistically significant. There was significant difference in the survival rates between the positive and negative marginal groups. Conclusion There is no significant difference between the two surgical approaches on the survival rate of patients, but the choice of surgical approach should be individualized. For esophageal obvious invasion patients, transthoracic surgery should be taken to reduce the positive rate of the upper margin.