胸中下段食管癌二野淋巴结清扫手术方式的探讨  

Evaluation of Two-field Lymphadenectomy in Middle and Lower Thoracic Esophageal Carcinoma

作　　者：兰碧洋[1] 黄绍华[1] 罗强[1] 张晓安[1] 马汇斌[1] 

机构地区：[1]广西民族医院胸心外科,南宁市530001

出　　处：《广西医学》2011年第10期1270-1272,共3页Guangxi Medical Journal

摘　　要：目的比较经左胸单切口、右胸胸腹二切口行中下段食管癌根治手术二野淋巴结清扫的优劣,探讨食管癌淋巴结清扫的最佳手术路径。方法回顾性分析185例手术切除中下段食管癌患者的临床资料。根据手术入路不同分为左胸入路组(A组)80例和右胸入路组(B组)105例,比较两组的胸/腹淋巴结清扫数、各区域淋巴结转移度、手术时间、术中出血量、术后并发症发生率、围术期病死率、生存率及术后恢复时间。结果经左胸单切口、右胸胸腹二切口行食管癌根治术在上纵隔淋巴结转移度分别是7.69%和11.97%,两组比较差异有统计学意义(P<0.05),围术期病死率、手术时间、出血量、术后恢复时间、生存率,两组比较差异无统计学意义(P>0.05)。结论食管癌根治术经右胸胸腹二切口入路对上纵隔淋巴结清扫、腹腔淋巴结清扫均有优势。Objective To compare the left breast single incision,right chest abdomen two-incision esophagectomy for two-field lymphadenectomy,and to discusse the advantages and disadvantages of lymphadenectomy of the best surgical approach. Methods 185 cases of surgical resection for middle and lower esophageal carcinoma were retrospectively analyzed. All patients were divided into right-transthoracic approach group （ n = 105 ） and left-transthoracic approach （n = 80）. The chest abdomen lymph node dissection number, regional lymph node metastasis degrees, operation time, blood loss ,perioperative mortality ,postoperative complications, survival rate and average recovery time were compared between the two groups. Results The difference of the lymph node metastasis degrees of left thorax with single incision and right thorax and abdomen with two incision was statistically significant（7.69% vs 11.97% ,P 〈 0.05 ） ; the difference of perioperative mortality, operation time, blood loss,complications,the average recovery time and survival rate between the two groups were not significant （P 〉 0.05）. Condusion Esophageal cancer with right chest abdomen two incisions has superiority in mediastinal lymphadenectomy and celiac lymphadenectomy.

关 键 词：食管癌 二野淋巴结清扫 手术路径 

分 类 号：R735.1[医药卫生—肿瘤]