CAJ | 학술논문

目的探讨胃底或胃-食管结合部肿瘤经腹和左侧膈肌切开路径手术的治疗效果.方法自2007年3月至2011年6月对26例进展期胃底贲门癌合并食管下段受肿瘤浸润患者(其中肿瘤侵犯贲门部18例,侵犯食管下段8例),先经腹按近端胃癌或全胃根治性分离,再经左侧膈肌切开路径进行食管下段和周围淋巴结清除的根治性切除术,随后将代胃空肠与中段食管吻合.结果全组患者未出现吻合口瘘并发症.随访时间8个月～4年10个月,平均14个月.全组进行胃镜和CT复查均无一例局部或吻合口复发.其中6例患者分别于术后2年4个月～4年10个月因腹腔内肿瘤广泛种植转移死亡.结论近端胃或胃-食管结合部肿瘤选择经腹部和左侧膈肌联合切口与经胸或胸腹联合切口比较,均具有手术创伤小和根治性切除效果,是近端胃癌或胃-食管结合部肿瘤最佳的手术路径.
목적 탐토위저혹위-식관결합부종류경복화좌측격기절개로경수술적치료효과.방법 자2007년3월지2011년6월대26례진전기위저분문암합병식관하단수종류침윤환자(기중종류침범분문부18례,침범식관하단8례),선경복안근단위암혹전위근치성분리,재경좌측격기절개로경진행식관하단화주위림파결청제적근치성절제술,수후장대위공장여중단식관문합.결과 전조환자미출현문합구루병발증.수방시간8개월～4년10개월,평균14개월.전조진행위경화CT복사균무일례국부혹문합구복발.기중6례환자분별우술후2년4개월～4년10개월인복강내종류엄범충식전이사망.결론 근단위혹위-식관결합부종류선택경복부화좌측격기연합절구여경흉혹흉복연합절구비교,균구유수술창상소화근치성절제효과,시근단위암혹위-식관결합부종류최가적수술로경.
Objective To investigate the efficacy of transabdominal and left transdiaphragmatic gastrectomy on malignant tumors of gastric fundus and esophagogastric junction.Methods From March 2007 to June 2011,26 cases of advanced gastric cardia carcinoma and complicated with esophagogastric junction inva jejunal interposition reconstruction (18 cases complicated with cardia invasion and 8 cases with distant esophageal invasion) underwent transabdominal and left transdiaphragmatic radical gastrectomy and esophagojejunostomy.Results All cases were followed up for 8 months to 58 months (average 14 months).No case was complicated with anastomotic fistula or local or anastomotic recurrence.Six cases died of abdominal transplant recurrence from 28 months to 58 months after operation.Conclusions Compared with transthoracic and trans-thoracicabdominal approachs,transabdominal and left transdiaphragmatic approach was the best in radical gastrectomy for malignant tumors of gastric fundus and esophagogastric junction.