Ivor Lewis食管切除术二野淋巴清扫治疗73例胸下段食管鳞癌的临床疗效  

Ivor Lewis Esophagectomy with Two-field Lymph Node Dissection for Squamous Cell Carcinoma of the Lower Thoracic Esophagus

作　　者：吴捷[1] 柴 周星明[2] 陈奇勋[2] 严福来[2] 

机构地区：[1]浙江大学医学院附属第二医院胸外科,浙江杭州310009 [2]浙江省肿瘤医院胸腹外科,浙江杭州310022

出　　处：《癌症》2007年第3期307-311,共5页Chinese Journal of Cancer

摘　　要：背景与目的:食管切除局部区域淋巴清扫是胸下段食管癌的主要治疗手段。本研究旨在评价Ivor Lewis食管切除术二野淋巴清扫治疗胸下段食管癌的临床效果。方法:选择1998年1月至2001年12月73例行Ivor Lewis食管切除术二野淋巴清扫的胸下段食管鳞癌病例,观察清扫的淋巴结数目、术后并发症发生率、死亡率等指标,Kaplan-Meier法进行生存分析。结果:术后并发症发生率15.1%,死亡率2.7%。淋巴结转移率71.2%,上纵隔淋巴转移率17.8%。Ⅰ期5例,Ⅱ期34例,Ⅲ期32例,Ⅳ期2例。总的5年生存率为23.3%。N0与N1病例5年生存率分别为38.1%与17.3%(P<0.01)。ⅡA、ⅡB、Ⅲ期病例的5年生存率分别是31.2%、27.8%、12.5%(P<0.01)。结论:Ivor Lewis食管切除术二野淋巴清扫治疗胸下段食管鳞癌是一项安全的手术,可增加完整切除(肉眼及镜下均无癌残留)机会。BACKGROUND ＆ OBJECTIVE： Esophagectomy with local regional lymph node dissection is the main treatment for lower thoracic esophageal carcinoma. This study was to assess the clinical outcomes of Ivor Lewis esophagectomy with two-field lymph node dissection for squamous cell carcinoma of the lower thoracic esophagus. METHODS, Clinical data of 73 patients with squamous cell carcinoma of the lower thoracic esophagus, who underwent Ivor Lewis esophagectomy with two-field lymph node dissection from Jan. 1998 to Dec. 2001, were analyzed retrospectively. Kaplan-Meier method was used for survival analysis. RESULTS, The morbidity of postoperative complications was 15.1% with a 2.7% mortality rate. The lymph node metastasis rate was 71.2%; the metastasis rate of the upper mediastinal nodes was 17.8%. Of the 73 patients, 5 were at stage Ⅰ , 35 at stage Ⅱ, 32 at stage Ⅲ, and 2 at stage Ⅳ. The overall 5-year survival rate was 23.3%. The 5-year survival rate was 38.1% for N0 patients and 17.3% for N1 patients （P〈0.01）, and was 31.2% for stage Ⅱ a patients, 27.8% for stage Ⅱ b patients, and 12.5% for stage Ⅲ patients （P〈0.01）. CONCLUSION, Ivor Lewis esophagectomy with two-field lymph node dissection for squamous cell carcinoma of the lower thoracic esophagus is a safe operation, and may increase the chances of complete resection.

关 键 词：食管肿瘤/外科手术 Ivor Lewis食管切除术 二野淋巴清扫术 疗效 

分 类 号：R735.1[医药卫生—肿瘤]