摘要目的 探讨进展期胃癌手术路径的合理选择以及手术技巧与并发症的预防.方法 回顾总结2003-2006年经根治性手术治疗的36例胃上部癌的临床资料,其中经腹手术20例,经胸或胸腹联合手术16例.结果 经腹手术在缩小手术创伤、减少出血量及手术并发症方面占有一定的优势,安全性较好,但亦有一定的局限性.结论 手术路径的选择主要应依据肿瘤的具体情况而定,合理掌握指征.对于非贲门胃上部癌、食管侵犯在2 cm或以下者以及Bormann Ⅰ、Ⅱ型的胃上部癌应优先考虑经腹路径的手术.

abstractsObjective To explore the reasonable selection of operative pathway, surgical skill, and pre-vention of complication in superior advanced gastric carcinoma. Methods 36 patients with superior advanced gastric carcinoma received radical operation from 2003 to 2006 were reviewed. Twenty eases with abdominal in-cision and 16 cases with thoracotomy or badomino-thoracic incision. Results The comparative analysis indica-ted that abdominal incision had an advantage in reducing operative injury ,decreasing hemorrhage and complica-tion. Conclusion Selection of operative pathway must depend upon trmour conditions. Although abdominal re-section is a securer mode. but should be paid attention to the indications. On the condition of insuring radical treatment, especially for such eases of superior gastric carcinoma as non-cardiac part, oesophageal involvement ≤2 cm or Borrmann Ⅰ - Ⅱ type, abdominal resection ought to be top-priority.