经右胸-腹部双切口治疗食管中、上段癌  

Surgical treatment for the upper or mid-thoracic esophageal carcinoma by abdominal and right chest approaches

作　　者：杨立伟[1] 白世祥[1] 王雷[1] 

机构地区：[1]河北医科大学第四医院胸外科,石家庄市050011

出　　处：《江苏医药》2011年第6期671-672,共2页Jiangsu Medical Journal

基　　金：河北省普通高等学校强势特色学科肿瘤学建设经费资助项目[冀教高(2005)52号]

摘　　要：目的探讨经右胸-腹部双切口在治疗食管中、上段癌中的应用。方法比较经右胸-腹部双切口(A组,82例)、经左胸-颈部双切口(B组,65例)、经右胸-腹部颈部三切口(C组,106例)治疗食管中、上段癌的效果。结果三组肿瘤切除率、切缘阳性率、手术死亡率、5年生存率无明显差别。三组清扫淋巴结数目分别为A组(10.3±4.1)个,B组(9.8±4.5)个,C组(13.8±5.5)个,C组明显多于A、B两组(P<0.01);A组手术并发症发生率37.8%,明显低于C组的44.8%(P<0.01);A组吻合口瘘发生率明显低于B、C组(2.4%vs.10.8%、10.3%)(P<0.01)。结论经右胸-腹部双切口适用于治疗食管中、上段癌。Objective To compare the outcomes of surgery for upper or mid-thoracic esophageal carcinoma by abdominal and right chest approaches.Methods The outcomes of surgery were compared among 82 cases with two-incision via right chest（group A）,65 cases with two-incision via left chest（group B） and 106 cases with three-incision via right chest（group C）.Results There were no significant differences in the resection rate,the positive surgical margins rate,the mortality and the 5-year survival rate among three groups.The number of lymph nodes resected was more in group C than that in groups of A or B[（13.8±5.5） pieces vs.（9.8±4.5） pieces or（10.3±4.1） pieces]（P0.01）.The incedence rate of complication was lower in group A than that in group C（37.8% vs.44.8%）（P0.01）.The anastomotic leakage rate was lower in group A than that in groups of B and C（2.4% vs.10.8% and 10.3%）（P0.01）.Conclusion Two-incision via right chest is suitable for the surgery in patients with upper or mid-thoracic esophageal carcinoma.

关 键 词：食管癌 手术入路 

分 类 号：R735[医药卫生—肿瘤]