摘要
目的 探讨左胸和颈两切口食管癌切除术的手术适应证及其并发症的防治。方法 回顾性总结分析 1992年 1月至 2 0 0 2年 12月间 2 0 5 8例左胸、颈两切口食管癌切除术的临床资料。结果 术后痊愈出院 2 0 2 5例 ,临床治愈率为 98 4 0 % ,围手术期死亡 33例 ( 1 6 0 % )。术后病理证实淋巴结有转移者 895例 ,总转移率为 4 3 4 9% ,分组标记证实颈、胸、腹 3组淋巴结转移率分别为 5 12 % ( 10 7 2 0 5 8例 )、4 2 5 0 % ( 875 2 0 5 8例 )、2 1 19% ( 4 36 2 0 5 8例 )。残端癌发生率为 1 5 1% ( 31 2 0 5 8例 )。术后心电图异常者较术前增加 2 0 11% ( 4 13 2 0 5 8例 ) ,其他并发症发生率为 16 2 1% ( 334 2 0 5 8例 )。随访 1870例 ,随访率 90 86 %。术后总的 3、5年生存率分别为 6 1 2 2 % ( 895 14 6 2例 )、36 4 5 % ( 384 10 5 3例 )。结论 左胸、左颈两切口食管癌切除术具有食管癌病灶切除彻底 ,残端癌发生率低 ,可同时清除颈、胸、腹 3组淋巴结 。
Objective To discuss the indication, the prevention and treatment of complications of the esophagectomy through left thoracic and neck approach. Methods 2?058 cases of esophageal carcinoma were analyzed retrospectively. Results The success rate of this procedure was 98.40%, and 33 cases died postoperatively, the mortality was 1.60%(33/2?058). Lymph node metastases were presenting 895 cases. The gross rate of lymph node metastasis was 43.49%(895/2?058), the rates of 1ymph nodes metastasis in neck, chest and abdomen were 5.12%(107/2?058), 42.50%(875/2?058) and 21.19%(436/2?058), respective1y. The occurrence rate of residual carcinoma was 1.51%(31/2?058). The complication rate was 15.74%(324/2?058). 1?870 cases were followed-up (90.86%). The overall 3-, 5-year survival rates were 61.22%(895/1?462) and 36.45%(384/1?053), respectively. Conclusion The advantages of this approach were relatively radical resection, 1ow incidence of residual carcinoma, less severe complications.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2004年第6期338-340,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
