早中期食管贲门癌切除术伴迷走神经干保留术对预后影响的评价  

Evaluation of influence of early and mid-term esophageal cardiac cancer surgery with preserving vagus trunks on the prognosis

作　　者：李启驹[1] 杨光[1] 李军[2] 赵斌[1] 贺洪亮[2] 李宙童[1] 

机构地区：[1]上海市黄浦区中心医院外科,200002 [2]河南省新乡市中心医院胸瘤科

出　　处：《中国肿瘤临床与康复》2010年第1期69-71,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的研究评价早期和中期食管贲门癌切除手术伴迷走神经保留手术对根治性和预后生存的影响。方法选择在影像学上无明显外侵的早中期食管贲门癌136例,随机分为两组,比较保留组和对照组两组病例手术清扫淋巴结的数量;比较两组手术后淋巴结转移率和转移程度;比较两组的3,5年生存率。结果迷走神经保留组清扫淋巴结423个,对照组449个,两组差异无显著性(P>0.05)。手术后病理显示:迷走神经保留组淋巴结转移率为10.3%,转移度为2.8%;对照组分别为13.2%和4.5%,两组差异无显著性(P>0.05)。保留组术后3,5年生存率分别为75.5%和55.9%,对照组分别为72.1%和48.5%,两组差异亦无显著性(P>0.05)。结论早中期食管贲门癌切除伴迷走神经保留术,既能有效地保护术后消化功能,又不影响手术的根治性和手术后的生存时间。Objective To study and evaluate the influence of early and mid-term radical resection of esophageal cardiac cancer with preserving vagus trunks on survival and prognosis.Methods 136 patients without obvious external invasion on radiography were divided randomly into 2 groups：preserving vagus trunks group and the control group.The number of lymph node dissected,the rate and degree of lymph node metastasis after surgery,and three-and five-year survival rates between the two groups were compared.Results 423 lymph nodes and 449 lymph nodes were resected in preserving vagus trunks group and the control group respectively,there was no significant difference（P 〉 0.05）.Postoperative pathology revealed that in preserving vagus trunks group,lymph node metastasis rate was 10.3% and metastasis degree was 2.8%,while in the control group,those were 13.2% and 4.5% respectively,there was no significant difference（P 〉 0.05）.The three-year survival rate,five-year survival rate in the preserving vagus trunk group were 75.5% and 55.9% respectively,and in the control group were 72.1% and 48.5% respectively,also with no significant difference between the two groups（P 〉 0.05）.Conclusion Early and mid-term resection of esophageal cardiac cancer with preserving vagus trunks can effectively protect postoperative digestive function without affecting the radical surgery and postoperative survival time.

关 键 词：食管贲门肿瘤 迷走神经保留术 生存率 

分 类 号：R735[医药卫生—肿瘤]