[Surgical approach for carcinoma in the gastric cardia].
OBJECTIVE
To explore the optimal surgical approach for carcinoma in the gastric cardia.


METHODS
A total of 157 patients with carcinoma in the gastric cardia were assigned into 2 groups according to the surgical approaches adopted, namely transabdominal (57 patients) and transthoracic approaches (100 patients), and the therapeutic effects of the two approaches were compared.


RESULTS
In the transabdominal group, the average volume of intraoperative blood transfusion was 164.91+/-36.83 ml, average operative time 219.04+/-10.72 min and average hospital stay 14.39+/-1.39 d, with an average number of 6.04+/-2.84 lymph nodes removed. In the transthoracic group, the 4 parameters were 575.50+/-40.12 ml, 286.40+/-7.94 min, 20.32+/-0.81 d, and 3.62+/-2.56 respectively. None of the cases developed pleural effusion in the former group, which had a tumor recurrence rate of 22.80% within the follow-up period for 3 to 60 months. In contrast, 15 cases had pleural effusion in the latter group with a tumor recurrence rate of 41.00%. There was a significant difference between the two groups in terms of the therapeutic effects.


CONCLUSIONS
Transabdominal approach is the better alternative to transthoracic one for operation of carcinoma in the gastric cardia.
Zheng
Yong-bo
YB
Department of General Surgery, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Huang
Xiang-cheng
XC
He
Shi-ping
SP
Wu
Cheng-tang
CT
Yao
Xue-qing
XQ
D000328:Adult; D000368:Aged; D002299:Cardia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*