Surgical Approach Option For The Cardiac Carcinoma:a Case Control Study

Objective:The prevalence of adenocarcinoma of the esophagogastric junction is rising at an alarming rate, which has become the focus of attention. To analyze the relationship between the selection of operative approaches and curative effect in surgical treatment of the carcinoma of the esophagogastric junction.Methods:We conducted a case control study., and collected cases from the first Hospital of Lanzhou University, Gansu Provincial People’s Hospital and Tumor Hospital of Gansu Province from March31,2009to March31,2011. Patients, undergoing elective surgery, were included. The outcome measures included postoperative complications and economics.Statistical software was cited by SPSS13.0.Results:We finally included a total of141patients, of whom73patients underwent thoracic approach, of whom55patients underwent abdomen approach, and of whom12patients underwent thoracic and abdomen approach. Three groups were not statistically significant in gender, age, tumor size and TNM stage. The abdominal group, by which average operation time was21.82days and eating liquid time was7days, was significantly lower than the transthoracic group and thoracoabdominal group. The three groups was not statistically significant in ventilation time, get out of bed time, atelectasis, cardiac arrhythmia, anastomotic stenosis, anastomotic leakage, wound infection, pulmonary infection, pleural effusion, hospital mortality, upper and lower cutting edge of the positive rate; Compared with transthoracic group and thoracoabdominal group, the total cost of the abdominal group was39133.91yuan and was relatively low, but the difference was not statistically significant. Medical service fees, surgical fees, treatment fees, inspection fees, hospital expenses per capita and the average daily hospital charges among the three groups were not statistically significant.Conclusion:Transabdominal approach is preferred. However future prospective studies are required to validate the abdominal approach in the long-term efficacy.