PDF(Pubmed)
Abstract：
BACKGROUND: Adenocarcinoma of the esophagogastric junction has a center of origin within 5 cm of the esophagogastric junction. Surgical resection remains the main treatment. A transthoracic approach is recommended for Siewert I adenocarcinoma of the esophagogastric junction and a transabdominal approach is recommended for Siewert III adenocarcinoma of the esophagogastric junction. However, there is a need to determine the optimal surgical approach for Siewert II adenocarcinoma of the esophagogastric junction to improve lung function and the prognosis of patients.
OBJECTIVE: To investigate and compare the surgical effects, postoperative changes in pulmonary function, and prognoses of two approaches to treating combined esophagogastric cancer.
METHODS: One hundred and thirty-eight patients with combined esophagogastric cancer treated by general and thoracic surgeries in our hospital were selected. They were divided into group A comprising 70 patients (transabdominal approach) and group B comprising 68 patients (transthoracic approach) based on the surgical approach. The indexes related to surgical trauma, number of removed lymph nodes, indexes of lung function before and after surgery, survival rate, and survival duration of the two groups were compared 3 years after surgery.
RESULTS: The duration of surgery, length of hospital stay, and postoperative drainage duration of the patients in group A were shorter than those of the patients in group B, and the volume of blood loss caused by surgery was lower for group A than for group B (P < 0.05). At the one-month postoperative review, the first second, maximum ventilation volume, forceful lung volume, and lung volume values were higher for group A than for group B (P < 0.05). Preoperatively, the QLQ-OES18 scale scores of the patients in group A were higher than those in group B on re-evaluation at 3 mo postoperatively (P < 0.05). The surgical complication rate of the patients in group A was 10.00%, which was lower than that of patients in group B, which was 23.53% (P < 0.05).
CONCLUSIONS: Transabdominal and transthoracic surgical approaches are comparable in treating combined esophagogastric cancer; however, the former results in lesser surgical trauma, milder changes in pulmonary function, and fewer complications.
OBJECTIVE: To investigate and compare the surgical effects, postoperative changes in pulmonary function, and prognoses of two approaches to treating combined esophagogastric cancer.
METHODS: One hundred and thirty-eight patients with combined esophagogastric cancer treated by general and thoracic surgeries in our hospital were selected. They were divided into group A comprising 70 patients (transabdominal approach) and group B comprising 68 patients (transthoracic approach) based on the surgical approach. The indexes related to surgical trauma, number of removed lymph nodes, indexes of lung function before and after surgery, survival rate, and survival duration of the two groups were compared 3 years after surgery.
RESULTS: The duration of surgery, length of hospital stay, and postoperative drainage duration of the patients in group A were shorter than those of the patients in group B, and the volume of blood loss caused by surgery was lower for group A than for group B (P < 0.05). At the one-month postoperative review, the first second, maximum ventilation volume, forceful lung volume, and lung volume values were higher for group A than for group B (P < 0.05). Preoperatively, the QLQ-OES18 scale scores of the patients in group A were higher than those in group B on re-evaluation at 3 mo postoperatively (P < 0.05). The surgical complication rate of the patients in group A was 10.00%, which was lower than that of patients in group B, which was 23.53% (P < 0.05).
CONCLUSIONS: Transabdominal and transthoracic surgical approaches are comparable in treating combined esophagogastric cancer; however, the former results in lesser surgical trauma, milder changes in pulmonary function, and fewer complications.
摘要：
背景：食管胃结合部腺癌的起源中心在食管胃结合部5cm以内。手术切除仍然是主要的治疗方法。对于食管胃交界处的SiewertI腺癌，建议采用经胸方法，对于食管胃交界处的SiewertIII腺癌，建议采用经腹方法。然而,有必要确定SiewertII型食管胃结合部腺癌的最佳手术入路,以改善患者的肺功能和预后.
目的：为了研究和比较手术效果，术后肺功能的变化，两种联合治疗食管癌的方法及预后。
方法：选择我院收治的食管癌合并胃癌行普通及胸外科手术患者118例。根据手术方式将他们分为A组70例（经腹入路）和B组68例（经胸入路）。与手术创伤相关的指标，切除的淋巴结数量，手术前后肺功能指标,存活率,比较两组患者术后3年的生存期。
结果：手术持续时间，住院时间,术后引流时间A组明显短于B组,A组手术失血量低于B组(P<0.05)。术后1个月复查时,第一秒,最大通风量,用力的肺容量，A组肺容积值高于B组(P<0.05)。术前,术后3个月，A组患者的QLQ-OES18量表评分高于B组（P<0.05）。A组患者手术并发症发生率为10.00%,低于B组患者，为23.53%(P<0.05)。
结论：经腹和经胸两种手术方式在治疗合并食管癌方面具有可比性；然而，前者导致较小的手术创伤，肺功能的轻微变化，更少的并发症。
目的：为了研究和比较手术效果，术后肺功能的变化，两种联合治疗食管癌的方法及预后。
方法：选择我院收治的食管癌合并胃癌行普通及胸外科手术患者118例。根据手术方式将他们分为A组70例（经腹入路）和B组68例（经胸入路）。与手术创伤相关的指标，切除的淋巴结数量，手术前后肺功能指标,存活率,比较两组患者术后3年的生存期。
结果：手术持续时间，住院时间,术后引流时间A组明显短于B组,A组手术失血量低于B组(P<0.05)。术后1个月复查时,第一秒,最大通风量,用力的肺容量，A组肺容积值高于B组(P<0.05)。术前,术后3个月，A组患者的QLQ-OES18量表评分高于B组（P<0.05）。A组患者手术并发症发生率为10.00%,低于B组患者，为23.53%(P<0.05)。
结论：经腹和经胸两种手术方式在治疗合并食管癌方面具有可比性；然而，前者导致较小的手术创伤，肺功能的轻微变化，更少的并发症。
