Abstract：Objective To summarize the application value of improved left chest path in the operation of Siewert Ⅰ and Ⅱ type esophagogastric junction adenocarcinoma (EGJA). Methods The retrospective case-control study was conducted. The clinical data of 83 Siewert Ⅰ and Ⅱ type EGJA patients who underwent surgery in the First Affiliated Hospital of Bengbu Medical College from January 2010 to December 2012 were collected, including 63 males and 20 females with the age of 37-79 years. According to the different surgical approach, 65 patients were in the modified group, the incision was located in the eighth intercostal of the left chest, from the ernocostal joint to the location below the scapular angle; the 18 patients were in the abdominal group, the upper abdominal incision was taken. The operation time, postoperative complications, the number and region of lymph node being dissected were compared. Results The average operation time of the improved left thoracotomy and transabdominal approach groups were (186.40±19.45) minutes and (172.67±21.73) minutes, respectively. The average number of lymph node dissected in the left thoracotomy and transabdominal approach groups were 16.55± 2.42 and 12.06±2.88, there were significant differences between two groups(t=2.585,7.553, all P values＜0.05). The lymph node dissection rate of the mediastinum was 100% (65/65) in the improved left thoracotomy approach, but only 1/18 in the abdominal approach group, and there were significant differences (χ2=71.511, P＜0.01). There was no significant difference between the two groups in the rate of blood transfusion and the average time of hospitalization (all P values＞0.05). Conclusions The improved left thoracotomy is suitable for surgical treatment of Siewert Ⅰand Ⅱ type of EGJA. It is a simple, clear field of view and benefit for lymph node dissection methods.
张晖, 汪子书, 朱金海, 彭德峰, 王岩岩. 改良左胸入路在Siewert Ⅰ、Ⅱ型胃食管连接部腺癌手术中的应用[J]. 中华解剖与临床杂志, 2018, 23(3): 240-244.
Zhang Hui*, Wang Zhishu, Zhu Jinhai, Peng Defeng, Wang Yanyan. The application of improved left thoracotomy in the operation of Siewert Ⅰ and Ⅱ esophagogastric junction adenocarcinoma. Chinese Journal of Anatomy and Clinics, 2018, 23(3): 240-244.
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2018, Vol. 23 
