Comparison Of Thoracoabdminal Incision And Laparotomy Two Surgical Approach For Siewert Type-â…¡ Esophagogastric Carcinoma Junction In Short-term Curative Effect

Objective:Through compare the thoracoabdominal incision(TH) andlaparotomy(LA) two surgical approach in treatment of Siewert type-IIesophagogastric carcinoma junction(ECJ) of the comparative study, toexplore the reasonable surgical method.Method: A retrospective analysis of45patients with type-II ECJwith surgical treatde in China-Japan Union Hospital gastrointestinaldepartment of Jilin University from2012.9to2014.9. Compare with theTH and LA two surgical approach in hospital stays(HS), operationduration(OD), the number of lymph nodes harvested(LNH), lengthbetween esophagus margin and tumor(LMT), postoperative intensive careduration(ICD), blood transfusion during operation(BTO), perioperativemortality(PM),postoperative heart function failure(PHFF), postoperativerespiratory failure(PRF), postoperative pyothorax(PP), postoperativechylothorax(PC), postoperative abdminal infection(PAI), postoperativeadhesive intestinal obstruction(PAIO)(distance surgery time is6mounths),postoperative duodenal stump fistula(PDSF), postoperative anastomoticfistula(PAF), postoperative pancreatic fistula(PPF), postoperativepneumonia(PPN) and infection of incision wound(IIW). Result: There are45patients with type-II ECJ,35patients are malesand10patients are females. The sex difference do not reach statisticalsignificance(P>0.05). In these patients, the oldest is80years old and theyoungest is42years old, the age difference do not reach statisticalsignificance(P>0.05). Among these people, there are15patients with TH,another patients with LA. The group TH in HS is20.8days, OD is357min, LNH is28, LMT is5.05cm, ICD is37.2hours, BTO is2.75U(blood)and290ml(blood plasma), PM is0, PHFF is0, PRF is13.3%(2patients),PP is7%(1patients), PC is7%(1patients), PAI is0, PAIO is0, PDSF is0,PAF is0, PPF is13.3%(2patients), PPN is26.7%(4patients) and IIW is7%(1patients). The group LA HS is19.6days, OD is273min, LNH is22, LMT is1.18cm, ICD is35.4hours, BTO is2.55U(blood) and280ml(blood plasma), PM is0, PHFF is0, PRF is7%(2patients), PP is0,PC is0, PAI is0, PAIO is0, PDSF is0, PAF is0, PPF is16.7%(5patients), PPN is23.3%(7patients) and IIW is7%(2patients). Withstatistical analysis, the two groups do not reach statistical significance(P>0.05) in HS, ICD, BTO, PM, PHFF, PRF, PP, PC, PAI, PAIO, PDSF,PAF, PPF, PPN and IIW. But the two groups have statistical significance(P<0.05) in LMT,LNH and OD.Conclusion: These data tell us that the two groups do not havestatistical significance in HS, ICD, BTO and postoperativecomplications,which means there is no difference to the patients on these fields;TH group can cut more tissue beyond the tumor and more lymphnodes harvested than LA group which means TH group is cleaner thanLA group in cutting tumor.This data tell us patients with TH can livewithout tumor more time than LA;But patients with type-II ECJ treated asTH surgical approach takes more time in surgery than type-II ECJpatients with LA.For patients,it is a challenge.So we should estimate thesurgical value before TH surgery,patients can suffer TH surgery,we do THsurgery,otherwise,we do LAsurgery.