Clinical Analysis About Improved Thoracoabdominal Approach In Treating Cardiac Cancer

Objective:Cardia cancer is different from esophageal and gastric cancer malignant tumor. In recent years its incidence is increasing in China. Surgical treatment is an important means of cardia cancer, and has a variety of approaches. Joint incision is the ideal pathway, but its existence surgical trauma and heart lungs function influence is severer, more complex problems involving anatomy. This study aims to investigate the improvement of the operation pattern for cardia cancer and the clinical applications of this surgical operation.Methods:According to characteristics of the classic left joint thoracoabdominal incision, we design a improved thoracoabdominal approach. The experimental group and control group were compared with each other in a variety of aspects, from October2009to October2011, to my cardia cancer patients during the qualified contrast analysis, and will be20070month to September2009cardia cancer patients in our department left thoracotomy incision posterolateral radical excision compared to those two groups, were retrospectively analyzed, the group of27patients, compared to three groups of patients with each view between detection, observation index.Content:the timing of the operation, peri-operative bleeding, pull out chest tube time, hospital days commonly project, and focus on three groups of patients between the postoperative complications, lymph node dissection and move case, postoperative pain drug use and fly function change of list. Contrast analysis, evaluation of several approaches to observe clinical effect.Results:Total of12cases, compared with a group of7cases, the comparison group28cases, three groups of382cases, pieces resection lymph nodes, abdominal always transfer rate36.5%, the total transfer rate6.7%chest. Abdominal lymph node metastasis rate was significantly higher than the chest and abdominal lymph nodes,1.3.7group the highest average transfer rate was24%,36.5%,44.4%. And the chest for the next period of transfer lymph node mainly by the esophagus and lung ligament lymph nodes under the lymph nodes. Postoperative lung function recovery analysis revealed that a week on Wednesday after the incision lung function were significantly down which was classic joint group down the most obvious, two weeks, three weeks after the lung function were significantly improved, and the lung function recovery relatively fast. Postoperative pain drug use and type of time apparent contrast, improved incision group average use opioids for4times/example, obviously less than a group, the two groups controlled the average seven times and six times, use the total number of analgesic drug, incision group has also improved obviously less than a group contrast, two groups. The postoperative complications of2/12(16.7%), compared with a group of3/7(43%), contrast two groups of4/8(50%). Though complications is lighter, but three groups have m poor incidence relation. Currently case teacher, complications in the sure there is no statistical significance. Conclusion:The surgical approach is the key to radical cardia cancer surgery. The lymph node metastasis of cardia cancer is mainly celiac metastasis. A thorough clean lymph nodes and ensure the lower esophagus period of excision length, the necessary celiac combined multi-visceral resection, reasonable gastrointestinal reconstruction is the key to the success of cardia cancer surgery. And the choice of the trauma patients smaller surgical approach, ensure the operative field exposure is clearly an important prerequisite for success in the operation. The results show that the improved joint incision can significantly reduce the trauma of patients, guarantee of intraoperative peritoneal and chest lymph node thoroughly cleaning, lower esophagus here fully resection, reduce postoperative lung and incision infection. It deserves the further development in the future.