CAJ | 학술논문

目的探索治疗贲门部癌的手术入路新方法。方法经腹切开膈肌脚入路，用国产吻合器行纵隔内食管胃吻合89例、食管空肠吻合16例。结果在切除肿瘤及其上方7cm食管的同时,清除纵隔下部淋巴结，淋巴结转移率为20.9%。全组病例无手术死亡，无吻合口瘘，亦无食管切缘癌残留。术后并发症发生率4.76%，5年生存率39%。结论经腹切开膈肌脚纵隔内食管胃（空肠）机械吻合术，操作简便，术野暴露良好，创伤及生理扰乱较小，能有效地预防吻合口瘘，且便于切除足够长度食管和扩大淋巴结清除范围。适用于浸润食管长度<2cm的贲门部癌的外科治疗。
목적 탐색치료분문부암적수술입로신방법。방법 경복절개격기각입로，용국산문합기행종격내식관위문합89례、식관공장문합16례。결과 재절제종류급기상방7cm식관적동시,청제종격하부림파결，림파결전이솔위20.9%。전조병례무수술사망，무문합구루，역무식관절연암잔류。술후병발증발생솔4.76%，5년생존솔39%。결론 경복절개격기각종격내식관위（공장）궤계문합술，조작간편，술야폭로량호，창상급생리우란교소，능유효지예방문합구루，차편우절제족구장도식관화확대림파결청제범위。괄용우침윤식관장도<2cm적분문부암적외과치료。
Objective To evaluate a new surgical approach fo r the treatmentof carcinoma of the gastric cardia． Methods The GI stapler was used to perform intramediastinal e sophagogastrostomy for cardial carcinoma in 89 cases and esophago-jejunostomy i n 16 cases undergoing total gastrectomy by the transabdominal approach with inci sing the crus dextrum of the diaphragm. Results The average length resected of the lower part of the esophagus was over 7 cm. Intramediastinal lymph node metastasis was found by pathology in 2 0.9% (22/105).There was no operative mortality and the morbidity rate was 4.7 6%, 5 year survival rate was 39%. Conclusions The technique enables lymphadenectomy within the lower mediastinum a nd a sufficiently long enough resection of the esophagus. Transabdominal incisio n of the crus dextrum of the diaphragm makes a clear operative field for the pur pose of radical operation for carcinoma of the gastric cardia. The anastomosis b y GI stapler effectively prevents anastomotic leakage.This procedure is indicate d for cardial carcinoma cases in which the esophageal involvement is within 2 cm .