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目的:探讨经腹及左胸腹联合两种不同手术路径治疗SiewertⅡ/Ⅲ型食管胃结合部腺癌(AEG)的效果比较。方法:选取2016年1月至2019年1月苏北人民医院胸心外科收治的158例行手术治疗的SiewertⅡ/Ⅲ型AEG患者，男113例，女45例，年龄(160.78±6.54)岁，年龄范围为39～85岁，按照手术方式不同分为经腹组(n n＝76)与左胸腹联合组(n n＝82)。比较并分析两组患者术中手术时间、术中出血、肿瘤长径、腹段食管受累、消化道重建方式(食管空肠、食管残胃)、病理分级和术后并发症发生情况。n 结果:经腹组手术时间[(144.93±31.89)min]短于左胸腹联合组[(183.66±31.63)min]，术中出血[(97.23±55.34)ml]少于左胸腹联合组[(126.83±59.42)ml]，腹段食管受累[6.6%(5/76)]低于左胸腹联合组[48.8%(40/82)]，食管空肠[13.2%(10/76)]高于左胸腹联合组[3.7%(3/82)]，食管残胃[86.8%(66/76)]低于左胸腹联合组[96.3%(79/82)]，差异均有统计学意义(n P0.05)。经腹组患者住院时间[(16.78±3.78)d]与胸腹联合组[(16.51±6.07)d]比较，差异无统计学意义(n P＝0.745)。经腹组术后并发症发生率[13.1%(10/76)]低于胸腹联合组[28.1%(23/82)]，差异有统计学意义(n P＝0.021)。患者术后胸腔积液和肺部感染最常见，经胸腔穿刺抽液和抗感染治疗后，均能痊愈出院。n 结论:SiewertⅡ/Ⅲ型AEG经腹或左胸腹联合均能很好的完成手术，手术方式的选择也各有利弊。经腹组手术过程更加简单、安全，左胸腹联合入路更加有利于保证切缘阴性，但是手术时间相对较长，术中出血和术后并发症也相对较多。“,”Objective:To investigate the transabdominal and left thoracoabdominal approach in treatment of Siewert Ⅱ/Ⅲ adenocarcinoma esophagigastric(AEG) junction.Methods:A retrospective study was performed on 158 cases of patients with Siewert Ⅱ/Ⅲ AEG who were admitted from January 2016 to January 2019.113 males and 45 fenales were oged (66.78±6.54) years old, ranging from 39 to 85 years old.According to the different surgical methods, the patients were divided into the transabdominal group(n n=76) and the left thoracoabdominal combined group(n n=82). The intraoperative operative time, intraoperative hemorrhage, tumor length, abdominal esophageal involvement, digestive tract reconstruction(jejunum, gastric stump), pathological grading and postoperative complications in the two groups were compared and analyzed.n Results:The operative time[(144.93±31.89) min]in the transabdominal group was shorter than that in the left thoracoabdominal combined group[(183.66±31.63) min], intraoperative hemorrhage[(97.23±55.34) ml]was less than that in the left thoracoabdominal combined group[(126.83±59.42) ml], abdominal esophageal involvement[6.6%(5/76)]was lower than that in the left thoracoabdominal combined group[48.8%(40/82)], and esophageal jejunum[13.2%(10/76)]was higher than that in the left thoracoabdominal combined group[3.7%(3/82)]. Esophageal residual stomach[86.8%(66/76)]was lower than the left thoracoabdominal combined group[96.3%(79/82)], and the difference was statistically significant(n P0.05). There was no statistically significant difference(n P=0.745) in the length of hospital stay[(16.78±3.78) d]between the patients in the transabdominal group and those in the left thoracoabdominal combined group[(16.51±6.07) d]. The incidence of postoperative complications in the transabdominal group[13.1%(10/76)]was lower than that in the left thoracoabdominal combined group[28.1%(23/82)], and the difference was statistically significant(n P=0.021). Patients with postoperative pleural effusion and pulmonary infection are the most common, and can be cured and discharged after thoracopuncture and anti-infection treatment.n Conclusion:For SiewertⅡ/ⅢAEG, transabdominal or left thoracoabdominal combination can complete the operation well, and the choice of operation mode also has advantages and disadvantages.The transabdominal group is more simple and safe, and the left thoracoabdominal combined group is more conducive to ensure the negative cutting edge, however, the operation time is relatively long, and there are more intraoperative bleeding and postoperative complications.