河北医学
河北醫學
하북의학
HEBEI MEDICINE
2014年
8期
1281-1284
,共4页
食管胃交界部腺癌%淋巴结转移%手术方式
食管胃交界部腺癌%淋巴結轉移%手術方式
식관위교계부선암%림파결전이%수술방식
Adenocarcinoma of the esophagogastric junction%Lymph node metastasis%Operation method
目的：探究不同分型食管癌交界部腺癌（ AEG ）患者术后淋巴结转移规律以及手术方式的选择。方法：以我院2007年4月至2013年6月收治的158例食管癌胃交界部腺癌患者作为研究对象，所有患者均行经上腹、左胸入路淋巴清扫术，术后对各分型淋巴结转移的规律进行比较分析，并对手术方式的选择予以探讨。结果：158例患者术中共清扫淋巴结2449枚，平均每例清扫15．5枚，其中证实有105例患者伴有淋巴结转移，阳性淋巴结总数转移度711枚，转移度为29．0％，其中胸下段食管旁及下纵隔淋巴结转移以SiewertⅠ型患者为主。 AEG患者淋巴结转移与否在肿瘤大小和病理分期方面具有显著差异性（ P＜0．01），具有统计学意义。结论：AEG患者淋巴结转移与肿瘤大小和病理分期有着密切的关系，根据 Siewert分型，Ⅰ型、Ⅱ型的AEG患者均可选择经上腹左胸两切口，而Ⅲ型AEG患者则可选择单一经腹切口进行手术。
目的：探究不同分型食管癌交界部腺癌（ AEG ）患者術後淋巴結轉移規律以及手術方式的選擇。方法：以我院2007年4月至2013年6月收治的158例食管癌胃交界部腺癌患者作為研究對象，所有患者均行經上腹、左胸入路淋巴清掃術，術後對各分型淋巴結轉移的規律進行比較分析，併對手術方式的選擇予以探討。結果：158例患者術中共清掃淋巴結2449枚，平均每例清掃15．5枚，其中證實有105例患者伴有淋巴結轉移，暘性淋巴結總數轉移度711枚，轉移度為29．0％，其中胸下段食管徬及下縱隔淋巴結轉移以SiewertⅠ型患者為主。 AEG患者淋巴結轉移與否在腫瘤大小和病理分期方麵具有顯著差異性（ P＜0．01），具有統計學意義。結論：AEG患者淋巴結轉移與腫瘤大小和病理分期有著密切的關繫，根據 Siewert分型，Ⅰ型、Ⅱ型的AEG患者均可選擇經上腹左胸兩切口，而Ⅲ型AEG患者則可選擇單一經腹切口進行手術。
목적：탐구불동분형식관암교계부선암（ AEG ）환자술후림파결전이규률이급수술방식적선택。방법：이아원2007년4월지2013년6월수치적158례식관암위교계부선암환자작위연구대상，소유환자균행경상복、좌흉입로림파청소술，술후대각분형림파결전이적규률진행비교분석，병대수술방식적선택여이탐토。결과：158례환자술중공청소림파결2449매，평균매례청소15．5매，기중증실유105례환자반유림파결전이，양성림파결총수전이도711매，전이도위29．0％，기중흉하단식관방급하종격림파결전이이SiewertⅠ형환자위주。 AEG환자림파결전이여부재종류대소화병리분기방면구유현저차이성（ P＜0．01），구유통계학의의。결론：AEG환자림파결전이여종류대소화병리분기유착밀절적관계，근거 Siewert분형，Ⅰ형、Ⅱ형적AEG환자균가선택경상복좌흉량절구，이Ⅲ형AEG환자칙가선택단일경복절구진행수술。
Ob jective:To explore the transfer rule of lymph node metastasis in different types of adeno-carcinoma of boundary part of esophageal and stomach ( AEG) and surgical approach .Method:Selected 158 cases of esophageal stomach border of adenocarcinoma patients treated from April 2007 to June 2013 as the research objects , all the patients were taken surgery of lymph node cleaning through the abdomen , left tho-racic, and then comparative analyzed transfer rule of lymph node metastasis in different types of adenocarci -noma of boundary part of esophageal gastric , and discussed the surgical approach of adenocarcinoma of the esophagogastric junction .Result:2449 trunk of lymph nodes were cleaned in 158 patients , the average was 15.5 trunk of one case ,which confirmed 105 cases of patients with lymph node metastasis , and 711 trunks of positive lymph nodes metastasis degree , transfer degree was29 .0%, among them under the lower thoracic segment esophageal branch into mediastinal lymph node metastasis in Siewert Ⅰtype patients .AEG patients with lymph node metastasis or not has significant differences in tumor size and pathology staging (P <0.01), There was statistical significance .Conclusion:The transfer rule of lymph node metastasis in patients of AEG have close relations with the tumor size and pathology staging , according to Siewert parting , AEG patients with Ⅱtype Ⅰand of can choose the approach of abdomen and left breast , while AEG patients with type Ⅲof can choose single abdominal incision surgery .
