Treatment of advanced Siewert type Ⅱ esophagogastric junction adenocarcinoma by thoracoabdominal radical gastrectomy and D2 lymphadenectomy
10.3760/cma.j.issn.0253-3766.2016.08.012
- VernacularTitle:胸腹联合入路行根治性全胃切除治疗进展期SiewertⅡ型食管胃结合部腺癌
- Author:
Jian LI
1
;
Guangsen HAN
;
Yanghui CAO
;
Zengci RUN
;
Yuzhou ZHAO
;
Yingkun REN
;
Yanhui GU
;
Zhimeng LI
Author Information
1. 450003,河南省肿瘤医院 郑州大学附属肿瘤医院 普外科
- Keywords:
Adenocarcinoma of the esophagogastric junction;
Siewert type Ⅱ;
Surgical procedures,operative;
Lymphatic metastasis
- From:
Chinese Journal of Oncology
2016;38(8):628-631
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the advantages of thoracoabdominal radical gastrectomy for advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction. Methods Clinical data of 86 patients with Siewert type Ⅱ adennocarcinoma of the esophagogastric junction who received surgical treatment at the Henan Provincial Tumor Hospital from January 2015 to January 2016 were retrospectively analyzed. Among them, 44 patients underwent abdominal operation (abdominal group), and 42 patients underwent thoracoabdominal radical gastrectomy ( thoraco?abdominal group ) . The operation time, lymph node number, distance between the tumor and cutting edge, amount of intraoperational blood loss, postoperative pulmonary complications, and postoperative hospital stay in the two groups were compared. Results Comparing the thoracoabdominal group with the abdominal group, the number of removed lymph nodes was 41.57±9.22 vs. 35.09±10.61 (P<0.01), the number of removed mediastinal lymph nodes was 6.38±1.50 vs. 3.52±1.42 (P<0.01), the distance between the tumor and cut edge was (5.62±0.73) cm vs. (3.30±0.85) cm (P<0.01), whereas the operation time, intraoperative blood loss, postoperative pulmonary complications, occurrence of anastomotic leakage and hospital stay were statistically not significantly different ( P>0. 05 for all ) . Conclusions For patients with advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction, radical gastrectomy through thoracoabdominal approach can resect a longer segment of the esophagus, dissect more mediastinal lymph nodes, and does not increase post?operative complications and extend hospital stay, thus, exhibits obvious advantages in the surgical treatment of Siewert Ⅱadenocarcinoma of the esophagogastric junction.
