摘要
目的:比较左胸和右胸入路治疗胸中段食管癌的疗效差异。方法:回顾性分析我院2003年1月至2006年1月收治的420例胸中段食管鳞癌患者,其中经左胸入路250例(左胸组),经右胸入路170例(右胸组),比较两种路径治疗食管癌的并发症、淋巴结清扫情况及生存率。结果:左胸组与右胸组的并发症发生率分别为35.2%和50.6%(P<0.001);平均淋巴结清扫为(10.6±1.4)枚和(14.0±2.3)枚(t=-17.48,P<0.001);纵隔淋巴结复发率为54.4%和45.3%(P=0.67);1、2、3年总生存率为74.8%、54.0%、41.2%和72.9%、59.4%、50.6%,(χ2=2.819,P=0.093);1、2、3年无病生存率为58.0%、46.0%、36.0%和64.1%、54.1%、46.5%(χ2=4.073,P=0.044)。结论:经右胸入路操作复杂,并发症较多,但可减少淋巴结复发,并提高无病生存率。
Objectives To compare the different therapeutic effect of left or right transthoracic operative approach for middle thoracic esophageal cancer. Methods A total of 420 consecutive patients with middle thoracic esophageal squamous cell carcinoma （ESCC） received transthoracic esophagectomy between January 2003 and January 2006. The patients were divided into left approach group （n = 250） and right approach group （n = 170）. The postoperative complications, lymphagectomy, and survival rate of the two groups were compared retrospectively. Results The incidence of postoperative complications was higher in right approach group than in left approach group （50.6% vs 35.2%, P 〈 0.001）. The number of lymph nodes resected in right approach group was more than in left approach group （14.0 ± 2.3 vs 10.6 ± 1.4, P 〈 0.001）. Lymphatic recurrence rate was lower in right approach group than in left approach group （45.3% vs 54.4%, P = 0.67）. The 1-, 2-, 3- year overall survival rate was 74.8%, 54.0%, 41.2% in left approach group and 72.9%, 59.4%, 50.6% in right approach group （P = 0.093）. The 1-, 2-, 3-year disease-free survival rate was 58.0%, 46.0%, 36.0% in left approach group and 64.1%, 54.1%, 46.5% in right approach group respectively （χ2 = 4.073, P = 0.044）. Conclusion Right transthoracic resection increased the incidence of complications, but it could reduce lymphatic recurrence rate and increase disease-free survival rate.
出处
《实用医学杂志》
CAS
北大核心
2011年第13期2353-2356,共4页
The Journal of Practical Medicine
关键词
食管肿瘤/外科手术
手术并发症
淋巴结清扫
疗效
Esophagus neoplasm
Surgical operation
Postoperative complications
Lymphadenectomy
Efficacy
