The Choice Of Surgical Approach For Type Ⅱ, Ⅲ AEG Recent Clinical Curative Effect And The Influence Of Quality Of Life Of Postoperative Stage Retrospective Clinical Study Report

Objective:Type II and III were retrospectively analyzed AEG(integration of a esophageal gastric adenocarcinoma) abdominal hiatus incision approach for patients with via th oracic approach radical recent clinical curative effect and the influence of the qualit y of life, the comparative observation and explore the abdominal surgery and the c hest surgery compared the curative effect of two kinds of surgical approach.Methods:In October 2012- June 2014 in Shanxi Province tumor hospital between gener al and thoracic surgery were retrospectively in group II, and III AEG patients 630 cases, among them via thoracic approach group(Transthoracic that TT), 260 cases of Abdominal hiatus incision approach group(Abdominal transhiatal that TH), 370 cases, respectively on two groups of surgical resection, full stomach resection rate,on the cutting edge positive rate, average residual cleaning the lymph node number and incidence of postoperative cardiopulmonary complications, hemorrhage, infectio n, postoperative indices such as the average hospitalization days for statistical analy sis.Results:The strict into the group of 630 cases of postoperative data comparison research. Compared with statistical analysis of two groups of cases patients age, sex, the path of surgery, postoperative pathology, incised edge, cleaning on the total number of lymph nodes metastasis lymph node number, postoperative infection, postoperati ve death, postoperative hospitalization days, postoperative intestinal leakage and blee ding, infection of incision, postoperative cardiopulmonary complications such as ther e was no statistically significant difference(P > 0.05), the chest and abdominal gro up average hospitalization days of postoperative d(20.34±9.76) and(17.7±7.59) d,postoperative abdominal group average hospitalization time has obvious advantages i n the via chest group(P < 0.05); The thoracic and abdominal group average cleani ng the lymph node number is(14.99±7.68) and(22.07±11.58), abdominal group cle an lymph node number is via chest clean lymph node number has obvious advanta ges(P < 0.05). AEG patients’ main clinical symptoms include abdominal pain, dysp hagia in proportion to the corresponding symptoms were 57.4%, 49.7% respectively.According to a report after frozen section pathological analysis, AEG patients with pathological types in the majority with ulcer type, account for about 84.1%; Pathol ogical classification in the majority with adenocarcinoma class II, adenocarcinoma II- class III, poorly differentiated adenocarcinoma.Conclusion:Current medical surgical field commonly used surgical approach has 3 kinds:1, AEG approaches the chest combined incision surgical wound is larger than the r emaining two, surgical risk is higher, high incidence of postoperative cardiovascular complications, hemorrhage, infection, the recent curative effect and quality of life of patients with research against, therefore study did not adopt the surgical approac h. 2, AEG the chest surgery incision surgical approach, the incision exposure to ab dominal cavity than chest incision exposure is not sufficient for mediastinal lymph nodes and cleaning of the thorax, relative advantage. Due to the exposure of the pe ritoneal cavity is poorer, so bad for resection of abdominal lymph node cleaning and abdominal organs, so need from broken diaphragm when necessary, need to alert pyothorax, respiratory failure, chylothorax, and the occurrence of complications such as heart failure; 3, AEG the abdominal surgery incision surgical approach, althoug h the incision surgical trauma from the chest surgical approach AEG incision is rel atively small, and the surgical field exposure, the performer’s convenient and compr ehensive to probe the scope of tumor lesion and abdominal lymph node metastasis,more conducive to abdominal lymph node cleaning and abdominal multi-visceral re section, patients’ cardiopulmonary function disturbance is lighter, postoperative recov er relatively quickly, the residual rate of suncoo cut edge of esophageal cancer, ple ural and mediastinal lymph node removal surgery with difficulty. Therefore, II, III AEG surgical approach choice, abdominal via hiatus incision radical for lymph node cleaning, the abdomen surgical incision of the road has obvious advantage, may h ave a certain impact for prognosis.