Choice of surgical approach for Siewert Ⅱ and Ⅲ adenocarcinomas of the esophagogastric junction
10.3760/cma.j.issn.1671-0274.2014.09.019
- VernacularTitle:Siewert Ⅱ型和Ⅲ型食管胃结合部腺癌手术入路的选择
- Author:
Xiaoyu ZHANG
1
;
Jinyun YANG
;
Hong PING
;
Hongsheng ZUO
;
Lin YANG
Author Information
1. 徐州医学院附属淮安医院普通外科
- Keywords:
Adenocarcinomas of the esophagogastric junction;
Surgical procedures;
Surgical approach;
Lymph node dissection
- From:
Chinese Journal of Gastrointestinal Surgery
2014;(9):924-926
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the optimal surgical approach for Siewert Ⅱ and Ⅲadenocarcinoma of esophagogastric junction (AEG). Methods Clinical data of 135 patients with Siewert Ⅱand Ⅲ AEG treated in our hospital from August 2007 to August 2012 were analyzed retrospectively. Of 135 patients, 57 received transthoracic path for the stomach and proximal gastrectomy, second station lymph node resection (transthoracic group), and 78 cases received transabdominal hiatal approach (transabdominal group). The intraoperative lymph node harvested, postoperative complications and 5-year survival rate were compared between the two groups. Results There were no significant differences in the residual tumor positive margin and anastomotic leakage rate between the two groups (both P>0.05). Compared with transthoracic group, transabdominal group had more lymph node dissected (11.1±0.2 vs. 10.4±0.3, P=0.033], less postoperative cardiac[2.6%(2/78) vs. 19.3%(11/57), P<0.01] and pulmonary [7.7%(6/78) vs. 21.1%(12/57), P<0.05] morbidity, and short postoperative hospital stay[(13.4±0.1) d vs. (16.4±0.3) d, P<0.01]. A total of 128 cases were followed up for median 38 months (6 to 72 months). The 5-year survival rate in transthoracic group and transabdominal group was 29.8% and 34.6% respectively , without significant difference (P>0.05). Conclusion For the treatment of patients with Siewert Ⅱ and Ⅲ AEG, transabdominal hiatal approach can remove more lymph nodes , reduce postoperative cardiopulmonary morbidity and shorten hospital stay.
