关键词: Siewert Ⅱ/Ⅲ型食管胃结合部腺癌, 新辅助化疗, 腹腔镜全胃切除术, 开放全胃切除术

Abstract: [Abstract] Objective To investigate the efficacy and safety of advanced Siewert type Ⅱ/Ⅲ AEG neoadjuvant chemotherapy for retroperitoneal laparoscopic surgery and open surgery.Methods From January 2015 to December 2019,46 patients with locally advanced Siewert Ⅱ/Ⅲ AEG in Xishui People’s Hospital received neoadjuvant chemotherapy,and they were randomly divided into laparoscopic total gastrectomy(LATG)+D2 lymphadenectomy(LATG group,23 cases) or open total gastrectomy(OTG)+D2 lymphadenectomy(OTG group,23 cases).Results Both groups of patients completed preoperative neoadjuvant chemotherapy,and there was no interruption of treatment.Both groups achieved R0 resection and successfully completed the operation.There were significant differences in operation time[(251.53±32.35)min VS (233.68±24.13)min],intraoperative blood loss[(146.00±47.68)ml VS (181.21±42.54)ml],postoperative exhaust time[(2.89±0.56)d vs (3.24±0.34)d] and postoperative hospital stay[(12.65±2.17)d vs (14.59±3.58)d] between LATG group and OTG group(P<0.05).There was no significant difference in the number of lymph node dissection(32.19±3.23 VS 30.84±2.85)(P>0.05).In terms of postoperative complications,there was significant difference in wound infection(1 case,VS,4 cases)(P<0.05),but there was no significant difference in anastomotic stenosis(2 cases,vs,2 cases)(P>0.05).There were no serious complications such as anastomotic leakage,anastomotic bleeding and perioperative death in both groups.Conclusion After neoadjuvant chemotherapy for locally advanced Siewert Ⅱ/Ⅲ AEG patients,LATG group is equivalent to OTG group in radical tumor resection,lymph node dissection,postoperative bleeding and anastomotic leakage,but it has obvious advantages in intraoperative bleeding,postoperative intestinal function recovery,wound infection and postoperative hospital stay.

Key words: Siewert Ⅱ/Ⅲ AEG, neoadjuvant chemotherapy, laparoscopic total gastrectomy, open total gastrectomy